Clinical analysis of the large degree's vertical strabismus with the myectomy and anterior displacement of inferior oblique surgical treatment

Abstract

Objective To evaluate the patient's efficacy whose large degree's vertical strabismus treated by the myectomy and anterior displacement of inferior oblique surgery. Methods Included 53 patients with large degrees vertical deviation (≥ 15△) who treated by our department from January 2001 to June 2009 as the research object. All were treated by the myectomy (3-8mm) and anterior displacement of inferior oblique surgery, that was translocate the muscle 1mm before the temporal margin of inferior rectus. For the patients whose vertical gradient between the 15 △-25 △, the inferior oblique to be cut 3-5mm; For those patients whose vertical gradient above 25△, intraoperative observed after the inferior oblique to be cut 6mm and anterior displacement of inferior oblique surgery, then distribute the vertical gradient of the residual to the superior rectus /another inferior rectus of the eye according to principle of 1:1.5 (The upper and lower rectus moved back 1mmcan resettle the vertical deviation 1.5°). For the congenital absence of inferior rectus muscle in patients concurrent microcomea whose vertical gradient above 60△, the inferior oblique to be cut 6-8mm and anterior displacement of inferior oblique surgery. When accompanied horizontal strabismus, it was to restructure the strabismus according to principle of the horizontal strabismus at the same time. Results After 3-36mo reciprocal, with an average 18mo, 53 cases of vertical strabismus in patients with large degrees of stage Ⅰ cured 40 cases (75.5%), improved in 9 cases (17.0%), healed in 4 cases (7.5%). The total effective rate was 92.5%. Conclusions The large degree vertical strabismus patients who accompanied by inferior oblique hyperfunction,the first choice is the myectomy and anterior displacement of inferior oblique surgery. If it is insufficient to correct the vertical deviation, At the same time move back the superior rectus of the eye or move back inferior rectus of another eye. When combined with horizontal strabismus, all can receive stage Ⅰ correction. Key words: Inferiol oblique-hypertension; Myectomy; Anterior displacement surgery; Efficacy