Surgical treatment of superior oblique palsy: Predictors of outcome

Sanz, P. Merino; Escribano, José; Liaño, P. Gómez de; Yela, Rubén

doi:10.4103/ijo.ijo_699_16

Cited by 13 publications

(13 citation statements)

References 24 publications

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“…5–7 In the subset of patients with larger hypertropias in primary gaze (>15PD), the options are ill-defined with studies being smaller, most authors reporting that in cases of moderate angle more than one muscle is usually necessary to correct the vertical deviation. 5 In Sanz et al’s 8 series, when a second intervention was required (25%), inferior rectus recession was the most common surgery (9.2%).…”

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confidence: 99%

Inferior oblique recession associated to partial temporal inferior rectus recession in unilateral congenital superior oblique palsy

Burgos-Blasco

Hernández-García

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et al. 2021

European Journal of Ophthalmology

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Purpose: To evaluate the effectiveness of inferior oblique recession with contralateral partial temporal inferior rectus recession in patients with decompensated congenital unilateral superior oblique palsy (SOP) in correcting moderate vertical deviations in primary position. Methods: The medical records of patients with SOP who underwent inferior oblique recession with contralateral partial temporal inferior rectus recession were reviewed retrospectively. Vertical deviation in primary position, subjective torsion, diplopia, residual deviation, and the deviation decrease were evaluated. Results: Four patients (three males and one female, age range 29–56 years) with congenital unilateral SOP and mean vertical deviation of 21.0 ± 5.3PD (range 14–25D) in primary position were included. Mean correction of hypertropia in primary position with this technique was 15.5 ± 5.3PD (range 10–20PD). The mean hypertropia on gaze to the contralateral side changed from 30.0 ± 10.8D before surgery to 9.3 ± 7.9D after surgery. Torsion had a mean change of 4.8° of incyclodeviation. Preoperatively, all patients had head tilt and diplopia, which was resolved in all but one patient, who will need surgery. Patients were followed an average of 18 months. No adverse events were reported in any subjects. Conclusion: When performing recession of inferior oblique muscles in SOP associated to a full recession of the contralateral inferior rectus, there is a risk of overcorrection in those with moderate angles. Performing a partial recession in the contralateral inferior rectus eye corrected up to 20PD in primary position in our series, reducing this risk.

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Section: Introductionmentioning

confidence: 99%

Inferior oblique recession associated to partial temporal inferior rectus recession in unilateral congenital superior oblique palsy

Burgos-Blasco

Hernández-García

Orden

et al. 2021

European Journal of Ophthalmology

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“…The symptoms of SOP include abnormal head posture, facial asymmetry, asthenopia, and/or vertical diplopia. 1 Children with abnormal head posture are easily misdiagnosed as congenital muscular torticollis, 2 so that there are not a few patients with torticollis caused by SOP undergoing massage or even surgery on their neck. 3 The etiology of congenital SOP is not clear.…”

Section: Introductionmentioning

confidence: 99%

A single inferior rectus muscle surgery for treatment of congenital superior oblique palsy with small deviation in primary position

Huang

2021

European Journal of Ophthalmology

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Purpose: To evaluate outcomes of one muscle surgery for treatment of congenital superior oblique palsy (SOP) with Knapp Class V. Methods: Medical records were retrospectively reviewed for the patients with the congenital SOP type V who underwent surgical treatment through one muscle surgery between July 2015 and September 2020. The surgical procedure was resection-recession on the contralateral inferior rectus muscle of the hypertrophic or paretic eye. Vertical alignment at nine cardinal gaze positions, and resolution of the abnormal head posture were evaluated pre- and postoperatively. The follow-up was scheduled regularly at postoperative day 1, 1 week, 1 month, and followed by 2-month intervals until 18 months. Results: Twelve patients were included in this study, with a mean age of 6.4 years (range from 3 to 10 years). The mean follow-up period was 10.5 months after surgery (range from 6 to 18 months). The average vertical deviation at primary position was 6.33△ ± 2.93△ preoperatively and 0.75△ ± 1.14△ postoperatively ( p < 0.05). The average vertical deviation at downgaze was 23.33△ ± 4.75△ preoperatively and 1.92△ ± 1.62△ postoperatively ( p < 0.05). All patients had an abnormal head position preoperatively. Postoperative results indicated that the patients’ abnormal head position had been improved significantly. Conclusions: The surgical procedure of resection-recession on a single inferior rectus muscle is a successful intervention for the correction of superior oblique palsy (SOP) with Knapp Class V.

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“…With great interest, we read the article entitled “Surgical treatment of superior oblique palsy: Predictors of outcome” by Sanz et al . [ 1 ] and we thank them for this study.…”

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confidence: 99%

“…First, amblyopia was found to be a risk factor for reoperation. [ 1 ] However, the vertical deviation was not mentioned separately for amblyopic and nonamblyopic patients. It may be possible that amblyopic patients have more vertical deviation thus, requiring more than one surgical procedure and it may act as a confounding factor for reoperation.…”

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confidence: 99%