Tehran University of Medical Sciences
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Ahmad Ameri

Treatment of A and V Pattern Strabismus by Slanting Muscle Insertions in Farabi Eye Hospital

Authors: Dr. Ali-Reza Keshtcar-Jafari, Dr. Masoomeh TaherZadeh, Dr. Faramarz Anvari, Dr. Ahmad Ameri *, Dr. Iraj Ahadzadegan, Dr. Aso AliMahmoodi and Dr. Mohammad-Taher Rajabi
Journal of Current Ophthalmology, Vol.21, No.1, 2009,Page:41-46

Purpose: To evaluate outcome of surgically slanting extraocular muscle insertions in A and V-pattern strabismus.
Methods: In this prospective non-randomized interventional case series, we created a slanting surgical reinsertion line with a 3-4 mm difference between upper and lower corners of the muscles in 16 patients with A or V strabismus (V-Exotropia in 10 patients, A-Exotropia in 1 patient, V-Esotropia in 5 patients). Cases with moderate or marked overaction of oblique muscle were excluded. All patients were followed for 6 months.
Results: V-Exotropia: the average amount of V-pattern was 29.5
Dbefore and 9.2 Dafter surgery. Slanting surgery reduced the V-pattern in 10 of 10 patients. The mean amount of reduction was 20.3 D(P<0.0001). All anatomical muscle insertions were normal. V-Esotropia: the average amount of the V-pattern was 22.4 Dbefore and 13.2 Dafter surgery. Slanting surgery reduced V-pattern in 4 of 5 patients. The mean reduction was 9.2 Din the V-pattern (P<0.067) and 28 Din down gaze (P<0.003) and 22 Din primary position (P<0.014). A-Exotropia: (1 patient) A-pattern was 20 Dbefore and 6 Dafter surgery. Amount of pattern reduction was 14 D.
Conclusion: Slanting muscle insertion for correction of A and V strabismus is suitable procedure for reducing A and V-patterns.