Graded marginal recession: A surgical technique to correct small angle vertical deviations

Steven E. Brooks, Larissa Habib

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Purpose: To describe a novel muscle recession technique to surgically correct small angle vertical deviations in symptomatic adults with fusion potential. Methods: A novel technique involving a graded recession of the medial and lateral poles of a vertical rectus muscle, combined with graded medial and lateral tenotomy of the muscle, was used to treat small vertical deviations. A surgical nomogram was developed based on the configuration of the procedure and its predicted effects. Four patients with small angle hypertropia ranging from 1 to 5 prism diopters (PD) underwent the graded marginal recession procedure and were observed for up to 3 years. Results: Three of the four patients had successful correction of their strabismus and resolution of diplopia, with no complications or induced incomitance. One patient was initially orthotropic but showed a 2 PD regression 1 month postoperatively, eventually requiring additional surgery to achieve stable orthotropia. Conclusions: The graded marginal recession can be safely and effectively used to correct very small vertical deviations in adults with fusion potential. A surgical nomogram can be created to guide predicted corrections in increments of less than 0.5 PD.

Original languageEnglish (US)
Pages (from-to)85-89
Number of pages5
JournalJournal of Pediatric Ophthalmology and Strabismus
Issue number2
StatePublished - 2016
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Ophthalmology


Dive into the research topics of 'Graded marginal recession: A surgical technique to correct small angle vertical deviations'. Together they form a unique fingerprint.

Cite this