Chief Author: Dr.Prolima Thacker

Presenting Author: Dr.Richa Agarwal

Co Author(s): Dr.Chanana Priyanka, Dr.Himali Agarwal, Dr.Surabhi Kumari

Abstract

Purpose: To present the result of 2 different procedures in MED.Methods:Patient 1 had large angle hypotropia (> 45degrees) and -4 limitation of elevation in RT eye and tight IR.A staged surgical plan of IR recession followed by Augmented Knapps surgery was made.Patient 2 presented with ptosis and -3 upgaze limitation and hypotropia of 60 pd of RT eye.IR was free on FDT.5 mm IR recession with Modified Nishida’s procedure to SR was done.Results:Patient 1 showed no change in ocular alignment but IR became less tight. augmented Knapps surgery was done.Post operatively patient had primary gaze orthophoria and improved ocular motility.
Patient 2 post operatively patient was orthophoric with improvement in motility and bell’s.Conclusion:Augmented knapps and modified nishida’s are good options for large angle hypotropia.knapps can be done for large deviations but will require staged procedure when IR recession is needed, while nishida’s can be performed in same sitting with no risk of ASI