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SPECIAL ARTICLE Burton J. Kushner, MD nsertion slanting recessions or biased resections have been reported to be useful for treat- ing A- and V-pattern strabismus, convergence insufficiency, and convergence excess eso- tropia. Paradoxically, good results have been reported with methods that are opposite in I nature. For example, some researchers would recess the medial rectus muscles and slant the superior pole of each muscle back farther than the inferior pole (Simonsz/von Graefe method) for a V-pattern esotropia, and others would slant the inferior poles back farther (Bietti method). The Simonsz/von Graefe method seems to be based on sound concepts of oculomotor mechanics. The Bietti method has been justified based on a misquoting and misinterpretation of previous work by Alan Scott, MD. Probably neither method contributes substantially to the outcome of strabis- mus surgery because sarcomere remodeling should rapidly negate the effect of the slanting. Most likely it is the recession or resection itself that affects the outcome. Arch Ophthalmol. 2011;129(12):1620-1625 The terms A-pattern and V-pattern stra- have been most predominantly used: (1) bismus are used to describe vertically in- weakening of the oblique muscles if they comitant horizontal strabismus in which are overacting (inferior oblique muscles for there is
JAMA Ophthalmology – American Medical Association
Published: Dec 1, 2011
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