{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T19:26:08Z","timestamp":1754162768735,"version":"3.41.2"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>Induced vertical deviation is a potential complication following the Nishida procedure for the treatment of sixth nerve palsy. This study aims to compare different positioning techniques for the reduction of this complication.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We retrospectively examined medical records from consecutive patients who underwent the Nishida procedure, classifying them into three positioning groups: intra-quadrant (IQP), lateral rectus border (LRBP), and horizontal meridian (HMP). Surgical and pre\/postoperative data were compared.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Among the 27 included patients (8 IQP, 9 LRBP, 10 HMP), all three groups demonstrated similar reductions in esodeviation: IQP, 44.0\u2009\u00b1\u200918.7 Prism Diopters (PD); LRBP, 42.2\u2009\u00b1\u200915.3 PD; HMP, 42.2\u2009\u00b1\u20097.8 PD; (P\u2009=\u20090.675). After surgery, one patient in the IQP group developed hypertropia of 18 PD, necessitating a secondary surgery to treat the vertical diplopia. In the LRBP group, two patients had hypotropia of 30 PD and 10 PD, respectively, and one patient had hypertropia of 6 PD. In the HMP group, one patient initially had hypertropia of 2 PD, which resolved during subsequent follow-up. A lower incidence of induced vertical deviation was observed in the HMP (10%) and IQP (13%) groups compared to the LRBP group (33%). However, this difference did not reach statistical significance due to the small sample size.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>There is no statistically significant difference among the three positioning techniques (IQP, LRBP, HMP) in the correction of esodeviation and reduction of incidence of induced vertical deviation following Nishida procedure.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0329139","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T17:24:13Z","timestamp":1753896253000},"page":"e0329139","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of different positioning techniques for reduction of induced vertical deviation following Nishida procedure for the treatment of sixth nerve palsy"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4229-4946","authenticated-orcid":true,"given":"Chong-Bin","family":"Tsai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chien-Liang","family":"Fang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"pone.0329139.ref001","first-page":"248","article-title":"Uber schnentransplantation am ague","volume":"34","author":"E Hummelsheim","year":"1907","journal-title":"Ophthal Gesselschft"},{"issue":"5","key":"pone.0329139.ref002","first-page":"593","article-title":"A new type of tendon transplant operation for abducens paralysis","volume":"31","author":"RJ Schillinger","year":"1959","journal-title":"J Int Coll Surg"},{"key":"pone.0329139.ref003","first-page":"359","article-title":"Rectus muscle union: a new operation for paralysis of the rectus muscles","volume":"45","author":"CD Jensen","year":"1964","journal-title":"Trans Pac Coast Otoophthalmol Soc Annu Meet"},{"key":"pone.0329139.ref004","first-page":"2475","article-title":"An innovative approach to transposition surgery is effective in treatment of Duane\u2019s syndrome with esotropia","volume":"47","author":"SC Johnston","year":"2006","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"pone.0329139.ref005","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.ajo.2017.02.021","article-title":"Inferior rectus transposition: a novel procedure for abducens palsy","volume":"177","author":"FG Velez","year":"2017","journal-title":"Am J Ophthalmol"},{"issue":"3","key":"pone.0329139.ref006","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/S0021-5155(03)00021-2","article-title":"A muscle transposition procedure for abducens palsy, in which the halves of the vertical rectus muscle bellies are sutured onto the sclera","volume":"47","author":"Y Nishida","year":"2003","journal-title":"Jpn J Ophthalmol"},{"issue":"2","key":"pone.0329139.ref007","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/s10384-004-0151-2","article-title":"A simple muscle transposition procedure for abducens palsy without tenotomy or splitting muscles","volume":"49","author":"Y Nishida","year":"2005","journal-title":"Jpn J Ophthalmol"},{"issue":"3","key":"pone.0329139.ref008","doi-asserted-by":"crossref","first-page":"236","DOI":"10.4103\/joco.joco_42_21","article-title":"A review of transposition techniques for treatment of complete abducens nerve palsy","volume":"33","author":"MR Akbari","year":"2021","journal-title":"J Curr Ophthalmol"},{"issue":"3","key":"pone.0329139.ref009","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/0002-9394(79)90081-3","article-title":"An adjustable transposition procedure for abduction deficiences","volume":"87","author":"MR Carlson","year":"1979","journal-title":"Am J Ophthalmol"},{"issue":"3","key":"pone.0329139.ref010","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/S0002-9394(00)00805-9","article-title":"Modified transposition procedure of the vertical recti in sixth nerve palsy","volume":"131","author":"A Neugebauer","year":"2001","journal-title":"Am J Ophthalmol"},{"issue":"2","key":"pone.0329139.ref011","doi-asserted-by":"crossref","first-page":"75","DOI":"10.3928\/0191-3913-19940301-03","article-title":"Adjustable vertical rectus muscle transposition surgery","volume":"31","author":"DM Laby","year":"1994","journal-title":"J Pediatr Ophthalmol Strabismus"},{"issue":"4","key":"pone.0329139.ref012","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.jaapos.2009.02.009","article-title":"Augmented vertical rectus transposition surgery with single posterior fixation suture: modification of Foster technique","volume":"13","author":"MC Struck","year":"2009","journal-title":"J AAPOS"},{"issue":"5","key":"pone.0329139.ref013","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.jaapos.2010.08.004","article-title":"Adjustable suture technique for enhanced transposition surgery for extraocular muscles","volume":"14","author":"P Phamonvaechavan","year":"2010","journal-title":"J AAPOS"},{"issue":"2","key":"pone.0329139.ref014","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.jaapos.2011.11.010","article-title":"Intraoperative monitoring of torsion to prevent vertical deviations during augmented vertical rectus transposition surgery","volume":"16","author":"JM Holmes","year":"2012","journal-title":"J AAPOS"},{"issue":"4","key":"pone.0329139.ref015","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/j.ajo.2013.05.020","article-title":"Surgical results of a muscle transposition procedure for abducens palsy without tenotomy and muscle splitting","volume":"156","author":"S Muraki","year":"2013","journal-title":"Am J Ophthalmol"},{"issue":"3","key":"pone.0329139.ref016","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1080\/09273972.2018.1492621","article-title":"A modified vertical muscle transposition for the treatment of large-angle esotropia due to sixth nerve palsy","volume":"26","author":"A Sabermoghadam","year":"2018","journal-title":"Strabismus"},{"issue":"1","key":"pone.0329139.ref017","article-title":"Outcomes of modified vertical rectus belly transposition versus augmented superior rectus transposition for chronic abducens nerve palsy","volume":"25","author":"J Yao","year":"2021","journal-title":"J AAPOS"},{"issue":"9","key":"pone.0329139.ref018","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1001\/jamaophthalmol.2022.2856","article-title":"Effect of modified vertical rectus belly transposition vs augmented superior rectus transposition plus medial rectus recession for chronic sixth nerve palsy: a randomized clinical trial","volume":"140","author":"J Yao","year":"2022","journal-title":"JAMA Ophthalmol"},{"issue":"1","key":"pone.0329139.ref019","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1038\/s41433-021-01917-z","article-title":"A comparative multicentric long-term study of un-augmented modified Nishida procedure vs augmentation in unilateral sixth nerve palsy","volume":"37","author":"E Hernandez-Garc\u00eda","year":"2023","journal-title":"Eye (Lond)"},{"issue":"9","key":"pone.0329139.ref020","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1136\/bjophthalmol-2021-320751","article-title":"Three-muscle surgery for large-angle esotropia in chronic sixth nerve palsy: comparison of two approaches","volume":"107","author":"J Yao","year":"2023","journal-title":"Br J Ophthalmol"},{"key":"pone.0329139.ref021","first-page":"365","article-title":"An anatomical reevaluation of rectus muscle insertions","volume":"78","author":"L Apt","year":"1980","journal-title":"Trans Am Ophthalmol Soc"},{"issue":"5","key":"pone.0329139.ref022","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.jaapos.2004.07.006","article-title":"Costenbader Lecture. The efficacy of rectus muscle transposition surgery in esotropic Duane syndrome and VI nerve palsy","volume":"8","author":"AL Rosenbaum","year":"2004","journal-title":"J AAPOS"},{"issue":"10","key":"pone.0329139.ref023","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.1016\/j.jcrs.2010.05.019","article-title":"Detection of static cyclotorsion and compensation for dynamic cyclotorsion in laser in situ keratomileusis","volume":"36","author":"J-L Febbraro","year":"2010","journal-title":"J Cataract Refract Surg"},{"issue":"2","key":"pone.0329139.ref024","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.jaapos.2015.01.007","article-title":"Outcomes of three different vertical rectus muscle transposition procedures for complete abducens nerve palsy","volume":"19","author":"M del Pilar Gonz\u00e1lez","year":"2015","journal-title":"J AAPOS"},{"issue":"1","key":"pone.0329139.ref025","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.jaapos.2008.08.015","article-title":"Management of vertical deviations after vertical rectus transposition surgery","volume":"13","author":"AL Ruth","year":"2009","journal-title":"J AAPOS"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0329139","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T17:24:17Z","timestamp":1753896257000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0329139"}},"subtitle":[],"editor":[{"given":"Neelam","family":"Pawar","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,7,30]]},"references-count":25,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0329139","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2025,7,30]]}}}