title: [Partial rectus muscle transposition for strabismus with lateral rectus muscles paralysis].
abstract: OBJECTIVE
  To investigate surgical approach for paralytic strabismus with lateral rectus muscles paralysis and evaluate its clinical effects.
  
  
  METHODS
  Design retrospective, observational case series. 28 patients (31 eyes) who underwent augmented partial rectus muscle transposition (APRMT) in the treatment of paralytic strabismus with lateral rectus muscles paralysis from May 2009 to May 2011 at Eye & ENT Hospital of Fudan University were included in this study. The following data were analyzed: (1) The procedure that was performed, (2) The angle of deviation of primary position, (3) The presence of compensatory head posture, (4) The presence of diploma in the primary position, (5) The binocular single visual fields, (6) The motility of the affected eye.
  
  
  RESULTS
  According to the results of rectus muscle forced traction test and examination before and after operation, among 31 eyes in 28 patients, 8 eyes were treated with APRMT, 10 eyes were treated with recession of antagonistic muscle of paralytic rectus muscle combined with APRMT, 7 eyes were treated with APRMT and recession of yoke muscle, 6 eyes were treated with APRMT and recession of yoke muscle combined with recession of antagonistic muscle. 17 among 28 patients were orthotopic in the primary position while others were in mild under correction with deviation no more than 10 prism degrees during 5 months (range: 3-8 months) follow-up in average. The diploma and abnormal head posture were eliminated in 26 patients except one patient who was appeared with 10 prism degrees under correction postoperatively and was resolved by wearing prisms thereafter. Binocular single visual fields were extended from 27.0° ± 6.4 ° preoperatively to 40.5° ± 4.8 ° postoperatively (t = -34.692, P < 0.001). Ocular movement was improved from -4.9 ± 0.4 to -2.9 ± 0.9 postoperatively (t = -13.418, P < 0.001).
  
  
  CONCLUSIONS
  APRMT can safely and effectively correct the primary position in paralytic strabismus with lateral rectus muscles paralysis, eliminate the presence of diploma in primary position and abnormal head posture, and improve the ability of the ocular movement, furthermore, significantly expand the scope of binocular single visual fields. The results also demonstrate that rectus muscle forced traction test is a key measurement to determine the surgical procedure.
authors.affiliation: Department of Ophthalmology,Eye & ENT Hospital Affiliated to Fudan University, Key Laboratory of Myopia, Ministry of Health PR China, Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Liu
authors.forename: Xiao-hui
authors.initials: XH
authors.lastname: Zhang
authors.forename: Lei-lei
authors.initials: LL
authors.lastname: Zou
authors.forename: Li-wen
authors.initials: LW
authors.lastname: Huang
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.forename: Xing-tao
authors.initials: XT
authors.lastname: Zhou
authors.forename: Hao
authors.initials: H
authors.lastname: Zhou
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D009886:Ophthalmoplegia / Q000601:surgery*; D012189:Retrospective Studies; D013285:Strabismus / Q000601:surgery*