AIM: To analyze the causes and evaluate the surgical effect of A-V patterns strabismus.

METHODS: Clinical data of 106 caseswith A-V patterns strabismus in our hospital from January 2011 to December 2012 were retrospectively analyzed. Seventy patients with oblique muscle overaction were performed weakening oblique muscle surgery to treat A-V pattern. Twenty-six patients with no abnormality of oblique muscle and superior and inferior rectus muscle, and with >20^△ between gaze up 25° and down 25° in V pattern and with >15^△ between gaze up 25° and down 25° in A pattern were performed horizontal rectus muscle transposition to half to one muscle tendon. While ten patients with no obvious abnormality of oblique muscle and vertical rectus muscle, and with ≤20^△ between gaze up 25° and down 25° in V pattern and with ≤15^△ between gaze up 25°and down 25° in A pattern were only performed horizontal rectus muscle surgery.

RESULTS: No A-V patterns was defined asnormotopia and A-V patterns >10^△ was defined as overcorrection or undercorrection after surgery. In 106 cases, V pattern was corrected in 75 cases, overcorrected in 5 cases, undercorrected in 4 cases. A pattern was corrected in 15 cases, overcorrected in 3 cases, undercorrected in 4 cases. Horizontal strabismus >±10^△ was defined as overcorrection or undercorrection after surgery. Eighty-five cases were corrected, 11 cases were undercorrected, and 10 cases were overcorrected.

CONCLUSION: A-V patterns strabismus was caused mainly by abnormal extraocular muscle. A-V patterns with abnormal oblique movement were treated by oblique surgery and A-V patterns with normal oblique and vertical rectus movement were treated by horizontal rectus muscle transposition, both which corrected A-V patterns. Patients had good distance and near stereopsis postoperation. Binocular weakening oblique muscle surgery can correct primary ocular position, so surgical design of horizontal deviation about A-V patterns strabismus with abnormal oblique muscle was considered.