Postoperative Correction and Drift After Vertical Rectus Muscle Transposition for Total Sixth Cranial Nerve Palsy

Lindsay Rothfield, Kara M. Cavuoto, Daniela P. Reyes-Capo, Elizabeth A. Vanner, Sara F. Grace, Hilda Capo

Research output: Contribution to journalArticle

Abstract

PURPOSE: To determine the magnitude of change between the preoperative and postoperative alignment and amount of postoperative drift for two vertical rectus muscle transpositions (VRTs). METHODS: Retrospective review of medical records of patients with total sixth cranial nerve palsy who underwent VRT procedures. The primary outcome measure was the magnitude of esotropia in prism diopters (PD) at the preoperative and postoperative visits. RESULTS: Twenty-seven patients were included. Sixteen had full tendon transposition with Foster augmentation (FTT+FA) and 11 had partial tendon transposition with resection and simultaneous medial rectus recession (PTT+R+MRR). A larger correction was obtained with PTT+R+MRR (mean ± standard deviation [SD]: 52 ± 19 PD; range: 27 to 87 PD) when compared to FTT+FA (mean: 40 ± 13 PD; range: 15 to 68 PD). At postoperative month 2, a greater esotropic drift was noted in the PTT+R+MRR group (16 PD) than the FTT+FA group (6 PD). Although the difference in the amount of correction was not statistically significant (P = .071), the difference in the amount of drift was statistically significant (P = .009). CONCLUSIONS: There was a trend toward greater correction with PTT+R+MRR than FTT+ FA, but it was not statistically significant. FTT+FA had significantly less postoperative drift than PTT+R+MRR. The results suggest that a small immediate postoperative overcorrection may be desirable in some VRT procedures. [J Pediatr Ophthalmol Strabismus. 2019;56(4):238-242.].

Original languageEnglish (US)
Pages (from-to)238-242
Number of pages5
JournalJournal of pediatric ophthalmology and strabismus
Volume56
Issue number4
DOIs
StatePublished - Jul 1 2019

Fingerprint

Abducens Nerve Diseases
Muscles
Tendons
Cetirizine
Esotropia
Strabismus
Medical Records
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Ophthalmology

Cite this

Postoperative Correction and Drift After Vertical Rectus Muscle Transposition for Total Sixth Cranial Nerve Palsy. / Rothfield, Lindsay; Cavuoto, Kara M.; Reyes-Capo, Daniela P.; Vanner, Elizabeth A.; Grace, Sara F.; Capo, Hilda.

In: Journal of pediatric ophthalmology and strabismus, Vol. 56, No. 4, 01.07.2019, p. 238-242.

Research output: Contribution to journalArticle

Rothfield, Lindsay ; Cavuoto, Kara M. ; Reyes-Capo, Daniela P. ; Vanner, Elizabeth A. ; Grace, Sara F. ; Capo, Hilda. / Postoperative Correction and Drift After Vertical Rectus Muscle Transposition for Total Sixth Cranial Nerve Palsy. In: Journal of pediatric ophthalmology and strabismus. 2019 ; Vol. 56, No. 4. pp. 238-242.
@article{6fd28ffdd3ed4359a8b2ab880ead4296,
title = "Postoperative Correction and Drift After Vertical Rectus Muscle Transposition for Total Sixth Cranial Nerve Palsy",
abstract = "PURPOSE: To determine the magnitude of change between the preoperative and postoperative alignment and amount of postoperative drift for two vertical rectus muscle transpositions (VRTs). METHODS: Retrospective review of medical records of patients with total sixth cranial nerve palsy who underwent VRT procedures. The primary outcome measure was the magnitude of esotropia in prism diopters (PD) at the preoperative and postoperative visits. RESULTS: Twenty-seven patients were included. Sixteen had full tendon transposition with Foster augmentation (FTT+FA) and 11 had partial tendon transposition with resection and simultaneous medial rectus recession (PTT+R+MRR). A larger correction was obtained with PTT+R+MRR (mean ± standard deviation [SD]: 52 ± 19 PD; range: 27 to 87 PD) when compared to FTT+FA (mean: 40 ± 13 PD; range: 15 to 68 PD). At postoperative month 2, a greater esotropic drift was noted in the PTT+R+MRR group (16 PD) than the FTT+FA group (6 PD). Although the difference in the amount of correction was not statistically significant (P = .071), the difference in the amount of drift was statistically significant (P = .009). CONCLUSIONS: There was a trend toward greater correction with PTT+R+MRR than FTT+ FA, but it was not statistically significant. FTT+FA had significantly less postoperative drift than PTT+R+MRR. The results suggest that a small immediate postoperative overcorrection may be desirable in some VRT procedures. [J Pediatr Ophthalmol Strabismus. 2019;56(4):238-242.].",
author = "Lindsay Rothfield and Cavuoto, {Kara M.} and Reyes-Capo, {Daniela P.} and Vanner, {Elizabeth A.} and Grace, {Sara F.} and Hilda Capo",
year = "2019",
month = "7",
day = "1",
doi = "10.3928/01913913-20190322-01",
language = "English (US)",
volume = "56",
pages = "238--242",
journal = "Journal of Pediatric Ophthalmology and Strabismus",
issn = "0191-3913",
publisher = "Slack Incorporated",
number = "4",

}

TY - JOUR

T1 - Postoperative Correction and Drift After Vertical Rectus Muscle Transposition for Total Sixth Cranial Nerve Palsy

AU - Rothfield, Lindsay

AU - Cavuoto, Kara M.

AU - Reyes-Capo, Daniela P.

AU - Vanner, Elizabeth A.

AU - Grace, Sara F.

AU - Capo, Hilda

PY - 2019/7/1

Y1 - 2019/7/1

N2 - PURPOSE: To determine the magnitude of change between the preoperative and postoperative alignment and amount of postoperative drift for two vertical rectus muscle transpositions (VRTs). METHODS: Retrospective review of medical records of patients with total sixth cranial nerve palsy who underwent VRT procedures. The primary outcome measure was the magnitude of esotropia in prism diopters (PD) at the preoperative and postoperative visits. RESULTS: Twenty-seven patients were included. Sixteen had full tendon transposition with Foster augmentation (FTT+FA) and 11 had partial tendon transposition with resection and simultaneous medial rectus recession (PTT+R+MRR). A larger correction was obtained with PTT+R+MRR (mean ± standard deviation [SD]: 52 ± 19 PD; range: 27 to 87 PD) when compared to FTT+FA (mean: 40 ± 13 PD; range: 15 to 68 PD). At postoperative month 2, a greater esotropic drift was noted in the PTT+R+MRR group (16 PD) than the FTT+FA group (6 PD). Although the difference in the amount of correction was not statistically significant (P = .071), the difference in the amount of drift was statistically significant (P = .009). CONCLUSIONS: There was a trend toward greater correction with PTT+R+MRR than FTT+ FA, but it was not statistically significant. FTT+FA had significantly less postoperative drift than PTT+R+MRR. The results suggest that a small immediate postoperative overcorrection may be desirable in some VRT procedures. [J Pediatr Ophthalmol Strabismus. 2019;56(4):238-242.].

AB - PURPOSE: To determine the magnitude of change between the preoperative and postoperative alignment and amount of postoperative drift for two vertical rectus muscle transpositions (VRTs). METHODS: Retrospective review of medical records of patients with total sixth cranial nerve palsy who underwent VRT procedures. The primary outcome measure was the magnitude of esotropia in prism diopters (PD) at the preoperative and postoperative visits. RESULTS: Twenty-seven patients were included. Sixteen had full tendon transposition with Foster augmentation (FTT+FA) and 11 had partial tendon transposition with resection and simultaneous medial rectus recession (PTT+R+MRR). A larger correction was obtained with PTT+R+MRR (mean ± standard deviation [SD]: 52 ± 19 PD; range: 27 to 87 PD) when compared to FTT+FA (mean: 40 ± 13 PD; range: 15 to 68 PD). At postoperative month 2, a greater esotropic drift was noted in the PTT+R+MRR group (16 PD) than the FTT+FA group (6 PD). Although the difference in the amount of correction was not statistically significant (P = .071), the difference in the amount of drift was statistically significant (P = .009). CONCLUSIONS: There was a trend toward greater correction with PTT+R+MRR than FTT+ FA, but it was not statistically significant. FTT+FA had significantly less postoperative drift than PTT+R+MRR. The results suggest that a small immediate postoperative overcorrection may be desirable in some VRT procedures. [J Pediatr Ophthalmol Strabismus. 2019;56(4):238-242.].

UR - http://www.scopus.com/inward/record.url?scp=85070105573&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070105573&partnerID=8YFLogxK

U2 - 10.3928/01913913-20190322-01

DO - 10.3928/01913913-20190322-01

M3 - Article

C2 - 31322714

AN - SCOPUS:85070105573

VL - 56

SP - 238

EP - 242

JO - Journal of Pediatric Ophthalmology and Strabismus

JF - Journal of Pediatric Ophthalmology and Strabismus

SN - 0191-3913

IS - 4

ER -