The medical records of patients with congenital DEP were reviewed retrospectively. Patients were divided into three treatment groups: standard transposition (group A), Foster transposition (group B), and resection transposition (group C). Pre- and postoperative vertical deviation in primary position, ocular motility, and binocular vision were compared.
Thirty patients were enrolled. The pre- and postoperative deviations in group A were 34.7Δ ± 8.6Δ and 6.5Δ ± 6.5Δ; in group B, 38.6Δ ± 14.6Δ and 5.7Δ ± 9.3Δ; and in group C, 43.1Δ ± 10.3Δ and 8.5Δ ± 6.1Δ. The corrected vertical deviation of group B (32.9Δ ± 5.7Δ) and group C (34.6Δ ± 5.0Δ) were greater than that of group A (28.1Δ ± 3.6Δ; P = 0.03, 0.002). The pre- and postoperative measures of upgaze in group A were −3.7 and −1.8; in group B, −4.0 and −1.3; and in group C, −3.6 and −2.0. The average improved upgaze in group B (2.6 ± 0.5) was statistically significantly better than that in group A (1.9 ± 0.6) and group C (1.5 ± 0.5; P = 0.03, 0.002). There was no significant difference in the surgical effect on downgaze in three groups (P > 0.05). The surgical outcome was satisfactory in 19 (63.3%) patients with preoperative vertical devation of ≤40Δ.
All transpositions are reasonably effective in treating vertical deviations of <35Δ without obviously limiting downgaze in DEP. Augmented procedures could correct greater vertical deviation of 30Δ-40Δ. The Foster transposition demonstrates the strongest effect in improving upgaze.