Plication combined with vertical displacement of horizontal rectus muscles to treat combined horizontal and vertical deviations.

Purpose: To report the results of horizontal rectus muscle recession-plication with vertical displacement in the treatment of combined vertical and horizontal strabismus.

Methods: From October 2016 to December 2019, 15 patients with horizontal deviation of 15-60, 3 associated with vertical deviation of 8 and 12 with vertical deviation of 10-20, underwent horizontal strabismus surgery (recession-plication) in addition to vertical displacement of both horizontal rectus, half or total muscle width, depending on whether the amount of vertical strabismus was small (8) or large (10-20), respectively.

Results: A total of 15 patients (8 females) were included; average age at surgery was 27 years. All cases showed improvement in alignment of the eyes, with a single case showing a small residual vertical deviation (4).There were no intra- or postoperative complications.

Conclusions: This case series demonstrates the feasibility of this vessel-sparing recession-plication technique in the treatment of combined horizontal and vertical deviations, without the need to operate on vertical muscles.