Surgical interventions for vertical strabismus in superior oblique palsy

Chang, Melinda Y.; Coleman, Anne L.; Tseng, Victoria L.; Demer, Joseph L.

doi:10.1002/14651858.cd012447

Cited by 8 publications

(11 citation statements)

References 35 publications

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“…When our cases were examined, diplopia was determined more frequently in adults in a similar way. 10,11 Superior oblique muscle palsy may be bilateral. The degree of excyclotorsion is typically higher in bilateral cases than in unilateral cases.…”

Section: Discussionmentioning

confidence: 99%

Disinsertion- Distal Myektomi and Tucking of Inferior Oblique Combined with Superior Oblique Full Tendon Advancement in Superior Oblique Palsy.

KAYA¹,

BEĞENDİ

AKDERE

et al. 2022

Preprint

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PURPOSE: To evaluate the first results of disinsertion-distal myektomi and tucking of inferior oblique muscle combined with full tendon advancement of superior oblique muscle in the patients with Knapp II or III superior oblique palsy.METHODS: Disinsertion-distal myectomy and tucking of inferior oblique muscle combined Superior oblique muscle full tendon advancement surgery were performed under general anesthesia on 16 eyes of 13 patients with Knapp Class II or III superior oblique muscle palsy who were involved in the study. Before and after surgery, the degree of vertical deviation in the primary position, abnormal head position, the presence of diplopia, the amount of inferior oblique muscle hyperfunction and superior oblique muscle hypofunction, and the degree of torsion were examined, and the differences were compared. RESULTS: In the preoperative period, twelve of the cases had abnormal head position and two had diplopia. The difference between the preoperative and postoperative period, the amount of the inferior oblique muscle hyperfunction and the superior oblique muscle hypofunction, the degree of vertical deviation in the primary position, and the amount of torsion were found statistically significant (p <0.01).CONCLUSION: According to the first results, disinsertion-resection and tucking of inferior oblique muscle combined superior oblique muscle full tendon advancement surgery was an effective procedure in the patient with congenital and acquired Knapp Class II or III superior oblique muscle palsy.

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Section: Discussionmentioning

confidence: 99%

Disinsertion- Distal Myektomi and Tucking of Inferior Oblique Combined with Superior Oblique Full Tendon Advancement in Superior Oblique Palsy.

KAYA¹,

BEĞENDİ

AKDERE

et al. 2022

Preprint

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“…Finally, Chang et al reviewed four different IO muscle-weakening surgeries for vertical strabismus in superior oblique palsy: myectomy, recession, anterior transposition, and disinsertion. [19] They could not find highquality evidence to support recommendations for surgical treatment choice in patients with vertical strabismus due to superior oblique palsy.…”

Section: Discussionmentioning

confidence: 99%

Comparing Two Inferior Oblique Weakening Procedures: Disinsertion versus Myectomy

Aghdam

Asadi

Sanjari

et al. 2021

JOVR

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Purpose: To compare two methods for treating inferior oblique overaction (IOOA): disinsertion versus myectomy of the muscle. Methods: In this prospective interventional case series, patients were randomly assigned to undergo either IO myectomy or disinsertion. The changes in vertical and horizontal deviations following these two surgical procedures were evaluated. The postoperative IO function of grade 0 or +1 and the fundus extorsion of grade 0 or +1 was considered as the successful outcome. Results: Thirty-six patients (50 eyes) with a mean age of 12.67 ± 4.05 years were included. In the myectomy group, the mean preoperative hyperdeviation in adduction was 29.5 ± 9.32 prism diopter (PD), which decreased to 9.15 ± 7.86 PD after surgery (P = 0.001). In the disinsertion group, these measurements were 32.73 ± 12.42 and 12.65 ± 9.34 PD before and after the surgery, respectively (P = 0.001). The success rate of surgery based on the IOOA grading was 87.4% and 92.3% in the myectomy and disinsertion groups, respectively (P = 0.780). The successful correction rate of abnormal fundus torsion was 91.6% in the myectomy and 88.4% in the disinsertion group (P = 0.821). In comparison, 48% of the cases in the myectomy group and 50% in the disinsertion group were within the normal range of torsional position postoperatively (P = 0.786). There was no statistically significant difference in terms of changes in the horizontal or vertical deviations, V-pattern, and dissociated vertical deviation between the two groups. Conclusion: Both surgical techniques seem to be effective for treatment of inferior oblique muscle overaction.

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“…We did not pilot test the forms as specified in the protocol for this review as we included only two trials, which was the number of trials recommended for pilot testing the form (Chang 2016). Any discrepancies were resolved by discussion.…”

Section: Methodsmentioning

confidence: 99%

“… DIFFERENCES BETWEEN PROTOCOL AND REVIEW After publication of the protocol (Chang 2016), we modified the outcomes to include the proportion of participants with relief of symptoms. As patients may seek treatment due to symptomatic diplopia and because some patients may still be symptomatic even when meeting objective criterion for surgical success, we added this outcome to assess the patient’s experience following surgery.…”

mentioning

confidence: 99%

Surgical interventions for vertical strabismus in superior oblique palsy

Chang¹,

Coleman²,

Tseng³

et al. 2017

Cochrane Database of Systematic Reviews

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Background Superior oblique palsy is a common cause of vertical strabismus in adults and children. Patients may be symptomatic from binocular vertical diplopia or compensatory head tilt required to maintain single vision. Most patients who are symptomatic elect to undergo strabismus surgery, but the optimal surgical treatment for vertical strabismus in people with superior oblique palsy is unknown. Objectives To assess the relative effects of surgical treatments compared with another surgical intervention, non-surgical intervention, or observation for vertical strabismus in people with superior oblique palsy. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 12), MEDLINE Ovid (1946 to 13 December 2016), Embase Ovid (1947 to 13 December 2016), Latin American and Caribbean Health Sciences Literature Database (LILACS) (1982 to 13 December 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch); searched 13 December 2016, ClinicalTrials.gov (www.clinicaltrials.gov); searched 13 December 2016, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 13 December 2016. We did not use any date or language restrictions in the electronic searches for trials. Selection criteria We included randomized trials that compared at least one type of surgical intervention to another surgical or non-surgical intervention or observation. Data collection and analysis Two review authors independently completed eligibility screening, data abstraction, ’Risk of bias’ assessment, and grading of the evidence. Main results We identified two randomized trials comparing four different surgical treatments for this condition, two methods in each trial. The studies included a total of 45 children and adults. The surgical treatments were all procedures to weaken the ipsilateral inferior oblique muscle. One study compared inferior oblique myectomy to recession of 10 mm; the other study compared inferior oblique disinsertion to anterior transposition (2 mm anterior to the temporal border of the inferior rectus insertion). We judged both studies to be at unclear risk of bias due to incomplete reporting of methods and other methodological deficiencies. Neither study reported data on the primary outcome of this review, which was the proportion of participants with postoperative surgical success, defined as hypertropia less than 3 prism diopters (PD) in primary gaze. However, both studies reported the average reduction in hypertropia in primary gaze. One study found that at 12 months’ postoperatively the average decrease in hypertropia was higher in participants who underwent inferior oblique myectomy than in those who underwent recession, however data were not available for statistical comparison. The other trial found that after at least six months of follow-up, the mean decrease in primary position hypertropia was lower in participants who und...

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Surgical interventions for vertical strabismus in superior oblique palsy

Abstract: This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:To assess the relative effects of different surgical treatments for vertical strabismus in people with superior oblique palsy.

Cited by 8 publications

References 35 publications

Disinsertion- Distal Myektomi and Tucking of Inferior Oblique Combined with Superior Oblique Full Tendon Advancement in Superior Oblique Palsy.

Disinsertion- Distal Myektomi and Tucking of Inferior Oblique Combined with Superior Oblique Full Tendon Advancement in Superior Oblique Palsy.

Comparing Two Inferior Oblique Weakening Procedures: Disinsertion versus Myectomy

Surgical interventions for vertical strabismus in superior oblique palsy

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