Modified vertical rectus belly transposition plus medial rectus recession promising option for chronic sixth nerve palsy

Results:

• 25 eligible participants with a mean (SD) age of 45.4 (12.6) years participated in the study.
• Of the total 10 were male participants and 15 were female participants.
• Thirteen participants were randomly assigned to the VRBT group, and 12 were randomly assigned to the SRT group.
• At baseline, the mean horizontal deviation was 65.7 prism diopters (Δ) in the VRBT group and 60.5Δ in the SRT group.
• Similar amounts of MRc were performed in both groups. At 6 months, the horizontal deviation changed by 66.3Δ in the VRBT group and by 51.5Δ in the SRT group from baseline.
• The adjusted group difference was 10.9Δ, favoring the VRBT group.
• Four times as many participants corrected more than 60Δ with mVRBT-MRc compared with aSRT-MRc.
• The group difference in the improvement of abduction limitation was −0.2.
• Although there was a higher proportion of under correction in the SRT group, no differences were identified for other suboptimal outcomes between groups. 

Thus, the researchers concluded that mVRBT-MRc showed a better effect in correcting esotropia than aSRT-MRc and they also suggested that mVRBT-MRc may be a promising alternative surgical procedure for chronic sixth nerve palsy, particularly for large esotropia of more than 60Δ. 

To read the full article, click here: 10.1001/jamaophthalmol.2022.2856 

Yao J, Jiang C, Wang X, et al. Effect of Modified Vertical Rectus Belly Transposition vs Augmented Superior Rectus Transposition Plus Medial Rectus Recession for Chronic Sixth Nerve Palsy: A Randomized Clinical Trial. JAMA Ophthalmol. 2022;140(9):872-879.