Introduction:

Cyclovertical strabismus refers to a type of misalignment in which the eyes have both horizontal and vertical deviations, often accompanied by abnormal torsional alignment. Cyclovertical strabismus surgery is a specialized procedure aimed at correcting these complex misalignments and restoring proper eye orientation. This article offers a comprehensive exploration of cyclovertical strabismus surgery, including its indications, surgical techniques, potential complications, and postoperative considerations.

Indications for Cyclovertical Strabismus Surgery:

Cyclovertical strabismus surgery is considered when:

• There is a significant torsional component to the misalignment, leading to diplopia and visual discomfort.
• Non-surgical interventions, such as prism glasses or vision therapy, have proven inadequate in managing the torsional component.
• The misalignment cannot be effectively addressed through conventional horizontal or vertical strabismus surgery.

Surgical Techniques:

Cyclovertical strabismus surgery involves precise adjustments of the eye muscles to correct both the vertical and torsional deviations. Common surgical techniques include:

• Oblique Muscle Surgery: Surgical procedures on the oblique eye muscles (superior and inferior oblique muscles) are often performed to correct torsional misalignment.
• Tendon Transposition: Transposing the insertion of the oblique muscles to a different location can alter their forces and correct the torsional component.

Potential Complications:

While cyclovertical strabismus surgery is generally safe, potential complications may include:

• Overcorrection or Undercorrection: Imbalance in muscle adjustments can lead to residual misalignment or opposite deviation.
• Induced Cyclotorsion: Surgical manipulation can inadvertently induce cyclotorsion, exacerbating the torsional misalignment.
• Diplopia: If the surgical outcome is not optimal, double vision (diplopia) may persist or worsen.

Postoperative Considerations:

After cyclovertical strabismus surgery, close postoperative monitoring is essential. Vision therapy exercises may be recommended to help the brain adapt to the new alignment and improve binocular vision. Prism glasses can also aid in managing any residual diplopia during the adjustment period.

Conclusion:

Cyclovertical strabismus surgery is a specialized procedure designed to correct complex misalignments involving both vertical and torsional deviations of the eyes. By understanding its indications, surgical techniques, potential complications, and postoperative considerations, patients and healthcare professionals can work together to achieve optimal visual outcomes and improve overall quality of life.

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