Surgery for complete vertical rectus paralysis combined with horizontal strabismus

Aims. to report outcomes of the simultaneous surgical correction of vertical rectus paralysis combined with moderate-to-large angle horizontal strabismus. methods. if a preoperative forced duction test was positive,antagonist muscle weakening surgery was performed,and then augmented partial rectus muscle transposition (aprmt) + partial horizontal rectus recession-resection was performed 2 months later. if a preoperative forced duction test was negative,aprmt + partial horizontal rectus recession-resection was performed. antagonistic muscle weakening surgery and/or conventional recession-resection of the horizontal and/or vertical muscles of the contralateral eye was performed 2 months later,as needed. results. ten patients with a mean age of 22.3 ± 13.0 years were included and mean follow-up was 7.1 months. the mean vertical deviation that aprmt corrected was 21.4 ± 3.7 pd (prism diopter). the absolute deviation in horizontal significantly decreased from a preoperative value of 48.5 ± 27.4 pd to a value of 3.0 ± 2.3 pd 6 months postoperatively. the movement score decreased from a value of -5 ± 0 preoperatively to a value of -2.7 ± 0.8 at 6 months postoperatively. conclusion. for patients with complete vertical rectus paralysis combined with a moderate- to-large angle of horizontal strabismus,combined aprmt and partial horizontal rectus recession-resection is safe and effective for correcting vertical and horizontal strabismus. © 2014 leilei zou et al.