Partial tendon recession for small-angle vertical strabismus.

PURPOSE: To evaluate the effectiveness of the partial tendon recession procedure in correcting small-angle vertical deviations.

METHODS

The medical records of patients who underwent partial tendon recession (one pole) were reviewed retrospectively. Orthophoria was the primary outcome success criterion; residual deviation, torsion, and the dose-response relationship were also evaluated. A secondary analysis was performed on subsets of patients with thyroid eye disease (TED) and those with procedures on a muscle that had previous surgery.

RESULTS

A total of 53 procedures in 44 patients (average age, 58 years; age range 8-88 years) were evaluated. The mean preoperative vertical deviation was 4.3Δ ± 1.8Δ (range, 2Δ-9Δ); the mean postoperative vertical deviation was 0Δ ± 2.3Δ. The mean response to surgery was 1.5Δ/mm. In the entire cohort, 62% of the procedures resulted in orthophoria, but 82% of patients had resolution of vertical diplopia with a single procedure. In TED patients, 60% of the procedures resulted in orthophoria, whereas only 29% of procedures on previously operated muscles resulted in orthophoria.

CONCLUSIONS

Partial tendon recession of vertical rectus muscles reliably corrects small vertical deviations. This is equally true for patients with TED, but results are less predictable with reoperated muscles.