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Original article

The effectiveness of inferior transposition of the horizontal recti in improving symptoms in patients with a deficit of downgaze: a case series of nine patients

Authors:

Karen Russell,

Ninewells Hospital and Medical School, Dundee, GB
About Karen

BSc

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Shadrokji Nabili,

Ninewells Hospital and Medical School, Dundee, GB
About Shadrokji

MD MRCOphth MRCS

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Caroline J. MacEwen

Ninewells Hospital and Medical School, Dundee D1 9SY, GB
About Caroline J.

MD FRCS FRCOphth

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Abstract

Aim: To evaluate the outcome of inferior transposi­tion of the horizontal recti in patients with reduced down gaze in one eye.

Methods: The case notes of 9 patients who underwent inferior transposition of horizontal recti were retro­spectively reviewed. The pre- and post-operative orthoptic findings are presented and the outcome of surgery discussed.

Results: Indication for surgery was a reduction in downgaze, caused by trauma in 5 cases, fourth nerve palsy in 3 cases and in 1 case decompensated congenital fourth nerve palsy in association with a facial fracture. The median vertical deviation in the primary position was 14Δ pre-operatively (range 4-25Δ) reducing to 3Δ post-operatively (range 0-13Δ). No patient was overcorrected in downgaze. Pre- and post-operative Hess chart scores indicated a reduc­tion in vertical displacement for all patients. Bino­cular single vision (BSV) scores demonstrated a more centralised field of BSV in all but 1 patient.

Conclusions: Inferior transposition is useful in patients with poor depression in one eye. It improves downgaze, centralises the field of BSV and relieves symptoms of diplopia.
DOI: https://doi.org/10.22599/bioj.199
How to Cite: Russell, K., Nabili, S. and MacEwen, C.J., 2006. The effectiveness of inferior transposition of the horizontal recti in improving symptoms in patients with a deficit of downgaze: a case series of nine patients. British and Irish Orthoptic Journal, 3, pp.32–36. DOI: http://doi.org/10.22599/bioj.199
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Published on 01 Jan 2006.
Peer Reviewed

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