Skew transposition of vertical rectus muscles for excyclovertical deviation

Purpose: The authors established a surgical treatment for excyclovertical s trabismus in which either the inferior rectus muscle or the superior rectus muscle was transposed diagonally. The effects and the safety of the proced ure, called skew transposition, were studied. Methods: Eighteen operations using local anesthesia with eye drops were per formed on 17 cases, including 10 with superior oblique palsy. Diplopia was checked during the operation with the cooperation of each patient. Both the clinical findings and eye deviation were examined during observation perio ds. Results: After the first operation, the diplopia in the primary position ha d disappeared in 10 cases and had improved in the other 7. The average effe ct of all operations on excyclodeviation was a correction of 6.2 degrees in the primary position. In the 7 cases of superior oblique palsy that receiv ed nasal recession of the inferior rectus muscle, the average correction of excyclodeviation was 6.4 degrees, and vertical deviation improved 1.8 degr ees per 1 mm of recession. In no case did the diplopia worsen, nor were the re any complications. Conclusions: This safe procedure facilitates the simultaneous improvement o f both excyclo and vertical deviations. It may become the treatment of choi ce far excyclovertical strabismus. (C) 2000 Japanese Ophthalmological Socie ty.