Partial rectus muscle tenotomy for treatment of small-angle strabismus

Abstract

IntroductionSmall deviations of ocular alignment are often treated with prism in spectacle correction. Circumstances in which patients desire not to wear spectacles preclude use of prism. Surgical correction of deviations is commonly accomplished by recession, resection or transposition of the extraocular muscles. Situations where the deviating angle is too small to be reliably corrected by these procedures present need for alternative management. This study sought to analyze the efficacy and predictability of partial tenotomy for treating small angle deviations. Patients treated by partial tenotomy were undergoing strabismus surgery for a second deviation along a different axis.MethodsA single-center, 21-month retrospective chart review performed of patients with a small-angle deviation [<6Δ] who underwent partial tenotomy of a rectus muscle without concomitant procedures to correct deviations along the same axis returned nine subjects. Pre- and postoperative measurements were compared to analyze the efficacy and predictability of partial tenotomy.ResultsMean preoperatively deviation was 4.7Δ ± 1.6Δ, mean postoperative deviation was 0Δ ± 1Δ. Six patients underwent partial tenotomy of an inferior rectus muscle, two of a medial rectus, and one of a lateral rectus. A paired t-test showed the means difference of 4.67Δ to be statistically significant (P < 0.0001).DiscussionPartial rectus muscle tenotomy can produce predictable results, with half-tendon width tenotomies producing an average of 4.67Δ of correction.ConclusionsPartial rectus muscle tenotomy should be considered a reliable treatment option for small-angle strabismus. IntroductionSmall deviations of ocular alignment are often treated with prism in spectacle correction. Circumstances in which patients desire not to wear spectacles preclude use of prism. Surgical correction of deviations is commonly accomplished by recession, resection or transposition of the extraocular muscles. Situations where the deviating angle is too small to be reliably corrected by these procedures present need for alternative management. This study sought to analyze the efficacy and predictability of partial tenotomy for treating small angle deviations. Patients treated by partial tenotomy were undergoing strabismus surgery for a second deviation along a different axis. Small deviations of ocular alignment are often treated with prism in spectacle correction. Circumstances in which patients desire not to wear spectacles preclude use of prism. Surgical correction of deviations is commonly accomplished by recession, resection or transposition of the extraocular muscles. Situations where the deviating angle is too small to be reliably corrected by these procedures present need for alternative management. This study sought to analyze the efficacy and predictability of partial tenotomy for treating small angle deviations. Patients treated by partial tenotomy were undergoing strabismus surgery for a second deviation along a different axis. MethodsA single-center, 21-month retrospective chart review performed of patients with a small-angle deviation [<6Δ] who underwent partial tenotomy of a rectus muscle without concomitant procedures to correct deviations along the same axis returned nine subjects. Pre- and postoperative measurements were compared to analyze the efficacy and predictability of partial tenotomy. A single-center, 21-month retrospective chart review performed of patients with a small-angle deviation [<6Δ] who underwent partial tenotomy of a rectus muscle without concomitant procedures to correct deviations along the same axis returned nine subjects. Pre- and postoperative measurements were compared to analyze the efficacy and predictability of partial tenotomy. ResultsMean preoperatively deviation was 4.7Δ ± 1.6Δ, mean postoperative deviation was 0Δ ± 1Δ. Six patients underwent partial tenotomy of an inferior rectus muscle, two of a medial rectus, and one of a lateral rectus. A paired t-test showed the means difference of 4.67Δ to be statistically significant (P < 0.0001). Mean preoperatively deviation was 4.7Δ ± 1.6Δ, mean postoperative deviation was 0Δ ± 1Δ. Six patients underwent partial tenotomy of an inferior rectus muscle, two of a medial rectus, and one of a lateral rectus. A paired t-test showed the means difference of 4.67Δ to be statistically significant (P < 0.0001). DiscussionPartial rectus muscle tenotomy can produce predictable results, with half-tendon width tenotomies producing an average of 4.67Δ of correction. Partial rectus muscle tenotomy can produce predictable results, with half-tendon width tenotomies producing an average of 4.67Δ of correction. ConclusionsPartial rectus muscle tenotomy should be considered a reliable treatment option for small-angle strabismus. Partial rectus muscle tenotomy should be considered a reliable treatment option for small-angle strabismus.