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Kakeru Sasaki, Takao Hayashi, Yusa Tane, Kozue Sasaki, Gaku Terauchi; Adjustable nasal transposition of the inferior rectus for superior oblique palsy using the “Cyclophorometer”. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2934.
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© ARVO (1962-2015); The Authors (2016-present)
We developed a new instrument “Cyclophorometer” to quantitatively assess cyclodeviation during strabismus surgery. We conducted an adjustable surgery involving horizontal transposition of the vertical rectus muscles using the Cyclophorometer and also evaluated its usefulness and the patient’s progress postoperatively.
We evaluated 33 patients with superior oblique palsy who underwent inferior rectus recession and nasal transposition (24 males, 9 females; average age, 53.1 years). The surgery was performed under local anesthesia with 4% lidocaine solution. The remaining cyclodeviation was measured during the surgery using the Cyclophorometer, and the amount of transposition was adjusted as necessary. In all patients, cyclodeviation was measured preoperatively, at the end of the surgery, and postoperatively (at 10 days, 3 months, and 1 year postoperatively).
All patients showed extorsion (average ± standard deviation, ex8.8 ± 4.0°) preoperatively. Of the 32 patients, 15 received a different amount of transposition as a result of the intraoperative cyclodeviation measurement. The average remaining cyclodeviation at the end of the surgery was ex0.61 ± 3.2°. The average postoperative cyclodeviations were ex2.9 ± 2.9° at 10 days, ex2.2 ± 2.3° at 3 months and ex2.3 ± 2.5° at 1 year. In all patients, cyclodiplopia was observed postoperatively but disappeared immediately after the surgery. Of the 32 patients, 28 did not exhibit cyclodiplopia at 1 year postoperatively.
Using the Cyclophorometer to measure cyclodeviation during strabismus surgery makes it easy to decide if any changes to the surgery type or amount of transposition are necessary. This method is also effective in reducing the number of surgeries to a minimum and in maintaining a good postoperative eye position.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
The Cyclophorometer is a plate-shaped instrument (8 cm × 24 cm) with a pair of fixed optical parts. The red Bagolini striated lens is fixed on the side of the fixing eye, and the rotatable green Maddox rod is placed the side of the measuring eye. It can noninvasively and quantitatively assess cyclodeviation in various postures and situations during strabismus surgery.
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