Quantifying Vertical Angle Kappa After Macular Translocation Surgery: A New Use for the Synoptophore

Abstract

Purpose: To report the measurement of vertical angle kappa and its application in patients after full macular translocation (MT360) and extraocular muscle surgery (to correct the resultant large angle torsion), in a prospective study. Methods: A custom slide was designed to quantify vertical angle kappa using the synoptophore. The measurement of the vertical angle kappa was performed in the eye that had the MT360, after the macular translocation surgery, extraocular muscle surgery (to correct torsion), and silicone oil removal, all in the same translocated eye. Information gathered included demographic, visual acuity, ocular motility, torsion, past ocular history, and synoptophore examination. Results: Fifty-three subjects met the inclusion criteria (patients who underwent upward MT360, with silicone oil tamponade and extraocular muscle surgery from 3/1999 to 6/2003, and who had visual acuity better than 20/200). Twenty-nine of these subjects were able to complete angle kappa measurement. The mean vertical angle kappa was 4.6 ± 1.4 degrees (n = 29) measured after MT360 and extraocular muscle surgery. The magnitude of vertical angle kappa did not correlate with either the amount of torsion after MT360, or the limitation of eye movement after both MT360 and extraocular muscle surgery. Conclusions: Vertical angle kappa can be measured using the synoptophore, and is increased above normal in eyes after MT360 and extraocular muscle surgery.