ONE-STAGE VERTICAL RECTUS MUSCLE RECESSION USING ADJUSTABLE SUTURES UNDER LOCAL-ANESTHESIA

Aims - To assess the results of visual arris alignment following one s tage adjustable suture surgery to correct vertical diplopia. Method - Eight patients with a mean age of 44.9 years (range 16-80 years) compl aining of vertical diplopia underwent rectus muscle recession under lo cal anaesthesia with intraoperative adjustment of sutures. Diplopia wa s secondary to superior oblique paresis in four patients, dysthyroid e ye disease in two patients, superior rectus paresis in one patient, an d one developed a consecutive deviation after previous squint surgery. The surgery consisted of seven single muscle recessions (six inferior recti and one superior rectus) and one two muscle recession (inferior and lateral recti). The surgery was performed under topical anaesthes ia supplemented with a subconjunctival injection of local anaesthetic over the muscle insertions. Results - The patients remained comfortabl e throughout their surgery. All had a reduction in their vertical devi ation. Six were asymptomatic and were eventually discharged. One had r esidual diplopia which was well tolerated without further intervention . One had persistent troublesome diplopia which was corrected by tempo rary Fresnel prisms. He became asymptomatic after further surgery of a 1 mm inferior rectus advancement. Conclusion - One stage adjustable s uture surgery is recommended in all cases of strabismus surgery when p ostoperative results would otherwise be unpredictable.