When is Isolated Inferior Oblique Muscle Surgery an Appropriate Treatment for Superior Oblique Palsy?
- 1 January 2006
- journal article
- research article
- Published by SAGE Publications in European Journal of Ophthalmology
- Vol. 16 (1), 10-16
- https://doi.org/10.1177/112067210601600103
Abstract
Purpose To evaluate the efficacy of isolated inferior oblique muscle weakening in the treatment of superior oblique palsy. Methods Forty-seven patients with superior oblique palsy underwent either single-muscle surgery (anteriorization or recession of the inferior oblique muscle) or two-muscle surgery (anteriorization of the inferior oblique muscle combined with recession of the contralateral inferior rectus muscle according to the amount of vertical deviation). In a retrospective non-comparative study the objective surgical effect was calculated as the difference between the deviation at the day before surgery and the deviations 6 weeks and at least 1 year after surgery. Pre- and postoperative sensorimotor status and subjective outcome were evaluated. Results In patients who underwent isolated inferior oblique muscle surgery the mean preoperative vertical deviation decreased from 15±9 (distance)/16±10 (near) prism diopters (PD) (anteriorization) and 7±5 (distance)/9±8 (near) PD (recession) to 4±4 (distance)/4±6 (near) PD (anteriorization) and 2±2 (distance)/2±3 (near) PD (recession) at the 1-year follow-up. In patients who underwent two-muscle surgery the mean vertical deviation decreased from 20±11 (distance)/21±10 (near) PD preoperatively and 6±7 (distance)/6±6 (near) PD at 1-year follow-up. Subjective assessment showed excellent scores among the patients treated with single-muscle surgery and slightly lower but also favorable scores among the patients treated with combined techniques. A direct comparison of the different outcome scores was not possible because of the more difficult initial situation in patients who underwent combined surgery. Conclusions Isolated inferior oblique muscle weakening is an effective treatment option for superior oblique palsy up to 15 PD of vertical deviation in primary position. Two-muscle surgery should be reserved for patients with larger vertical deviations.Keywords
This publication has 27 references indexed in Scilit:
- Unilateral anterior transposition of the inferior oblique muscle for correction of hypertropia in primary positionJournal of American Association for Pediatric Ophthalmology and Strabismus, 2003
- Anterior and nasal transposition of the inferior oblique musclesJournal of American Association for Pediatric Ophthalmology and Strabismus, 2003
- Masked bilateral superior oblique muscle paresis: A simple overcorrection phenomenon?Ophthalmology, 1998
- Restriction of elevation in abduction after inferior oblique anteriorizationJournal of American Association for Pediatric Ophthalmology and Strabismus, 1997
- Botulinum toxin in fourth nerve palsiesAustralian and New Zealand Journal of Ophthalmology, 1997
- Traitement chirurgical de la parésie du grand obliqueKlinische Monatsblätter für Augenheilkunde, 1994
- Tendon Laxity in Superior Oblique PalsyOphthalmology, 1992
- Denervation and Extirpation of the Inferior ObliqueOphthalmology, 1983
- A Technique for Recession of the Inferior Oblique MuscleAmerican Journal of Ophthalmology, 1972
- Simple technique for recession of the inferior oblique muscle.British Journal of Ophthalmology, 1970