Abstract
Purpose :
Partial tendon recession (PTR) has been shown to be effective in correction of small-angle vertical deviations. However, the efficacy of PTR has not been compared with that of full tendon recession (FTR), nor has it been assessed in the context of other concurrent muscle surgery that could affect vertical alignment.
Methods :
We present the preliminary results of a single-surgeon comparative case series of 11 adults (n=5 PTR, n=6 FTR), 4 of whom underwent ipsilateral Harada-Ito procedures (n=2 PTR, n=2 FTR). Vertical deviation was measured preoperatively and at subsequent clinic visits after strabismus surgery. Mann-Whitney U tests were used to compare mean pre- and post-procedure vertical deviation between the PTR and FTR groups. Occurrence of over-correction as well as need for prism correction or additional procedures were also documented.
Results :
Preoperative vertical deviation ranged from 2-10 (mean 4.6) prism diopters in the PTR group and 2-14 (mean 6.3) prism diopters in the FTR group. Postoperative vertical deviation ranged from 0-4 (mean 0.8) prism diopters in the PTR group and 0-8 (mean 2.0) prism diopters in the FTR group. There were no differences in the mean preoperative (U=10, p=0.21) or postoperative vertical deviation (U=8.5, p=0.14) between the PTR and the FTR groups. Over-correction occurred in 2 patients of the PTR group, and in 3 patients of the FTR group. In the PTR group, none of the patients required additional strabismus surgery, and only one patient required prism correction of residual vertical deviation.
Conclusions :
PTR may be an effective option for correction of small-angle vertical strabismus. Further research using larger prospective cohorts is needed to establish long-term efficacy compared with FTR, especially when combined with other procedures that may influence vertical alignment.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.