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Sang H. Rah, Jong Hyuck Lee, Young Chun Lee; The Change Of The Angle Of Deviation After Vertical Muscle Surgery In Hypertropia. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1580.
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Presently, a consensus on the correction level during vertical muscle surgery showing desirable postoperative outcomes has not been reached, and the correction level showing a good postoperative prognosis after vertical muscle surgery was investigated.
The sujects were 16 patients with hypertropia underwent the ipsilateral superior rectus recession or the contralateral inferior rectus recession and could be followed up for longer than 6 months. Through medical records, retrospectively, the ocular movement test and the angle of strabismus were examined. In regard to the surgical amount, depending on the experience of surgeon, 1 mm recession per 2.5 - 3.0 prism diopter was performed.
One week after surgery, concerning the correction level of the angle of deviation, undercorrection was 4 patients, orthotropia was 7 patients, and overcorrection was 5 patients. Examining the change of the vertical angle of deviation at the final follow up observation, all 4 patients who showed undercorrection one week after surgery maintained the undercorrection state, nonetheless, a tendency decreased slightly was shown. Among 7 patients showed orthotropia, 6 patients maintained orthotropia continuously at the final follow up observation, and 1 patient showed recurred hypertropia with the small angle of strabismus. 5 patients who showed overcorrection one week after surgery showed overcorrection continuously to the final follow up observation. In addition, the angle of deviation was increased gradually, and in 2 patients, reoperation for the consecutive hypertropia of the contralateral eye was required.
One week after vertical muscle surgery, the change of the angle of deviation according to the correction level was examined. It was found that in undercorrection as well as orthotropia cases, the angle of deviation was maintained stably. On the other hand, in overcorrection cases, the angle of deviation showed the tendency to be increased gradually with time, and thus it is thought that in vertical muscle surgery, it is desirable to aim orthotropia or slignt undercorrection.
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