Inferior oblique muscle anteriorization in congenital superior oblique palsy.
- Enz TJ University Hospital Zurich, Department of Ophthalmology, Zurich, Switzerland; Chair: Prof. Klara Landau.
- Jaggi GP University Hospital Zurich, Department of Ophthalmology, Zurich, Switzerland; Chair: Prof. Klara Landau.
- Weber KP University Hospital Zurich, Department of Ophthalmology, Zurich, Switzerland; Chair: Prof. Klara Landau.
- Sturm V University Hospital Zurich, Department of Ophthalmology, Zurich, Switzerland; Chair: Prof. Klara Landau.
- Landau K University Hospital Zurich, Department of Ophthalmology, Zurich, Switzerland; Chair: Prof. Klara Landau.
- 2014-04-29
Published in:
- Klinische Monatsblatter fur Augenheilkunde. - 2014
Adolescent
Adult
Aged
Child
Cohort Studies
Diplopia
Female
Humans
Male
Middle Aged
Oculomotor Muscles
Oculomotor Nerve Diseases
Ophthalmologic Surgical Procedures
Reconstructive Surgical Procedures
Retrospective Studies
Strabismus
Treatment Outcome
Young Adult
English
BACKGROUND
Inferior oblique muscle overaction of variable amounts is usually present with congenital superior oblique palsy. Inferior oblique muscle anteriorization has been described as a suitable surgical procedure in this entity. The aim of this study was to investigate the effect of inferior oblique muscle anteriorization in patients with congenital superior oblique palsy on vertical, torsional and horizontal alignment.
PATIENTS AND METHODS
The study was designed as an institutional retrospective cohort study. 45 patients with congenital superior oblique palsy (15 female, 30 male; mean age 36 years ± 19.2 SD, ranging from 6 to 75 years) underwent inferior oblique muscle anteriorization between 2000 and 2010. Preoperative amounts of vertical, torsional and horizontal deviation (using Harms tangent screen), measurements of Bielschowsky head tilt phenomenon as well as stereopsis (Lang test) were compared with findings three months and one year postoperatively.
RESULTS
Preoperative vertical deviation in primary position measured 10.1° (mean; range 0-19). Three months postoperatively vertical deviation was significantly reduced (p<0.001) to 4° (mean; range 0-20). After one year vertical deviation measured 3.5° (mean; range 0-15). The values three months postoperatively did not significantly differ from those one year postoperatively (p=0.46).
CONCLUSIONS
Inferior oblique muscle anteriorization leads to a significant and sustained improvement of ocular alignment in patients with congenital superior oblique palsy of various degrees of severity. Thus the procedure is recommendable as a first line treatment in this clinical situation.
Inferior oblique muscle overaction of variable amounts is usually present with congenital superior oblique palsy. Inferior oblique muscle anteriorization has been described as a suitable surgical procedure in this entity. The aim of this study was to investigate the effect of inferior oblique muscle anteriorization in patients with congenital superior oblique palsy on vertical, torsional and horizontal alignment.
PATIENTS AND METHODS
The study was designed as an institutional retrospective cohort study. 45 patients with congenital superior oblique palsy (15 female, 30 male; mean age 36 years ± 19.2 SD, ranging from 6 to 75 years) underwent inferior oblique muscle anteriorization between 2000 and 2010. Preoperative amounts of vertical, torsional and horizontal deviation (using Harms tangent screen), measurements of Bielschowsky head tilt phenomenon as well as stereopsis (Lang test) were compared with findings three months and one year postoperatively.
RESULTS
Preoperative vertical deviation in primary position measured 10.1° (mean; range 0-19). Three months postoperatively vertical deviation was significantly reduced (p<0.001) to 4° (mean; range 0-20). After one year vertical deviation measured 3.5° (mean; range 0-15). The values three months postoperatively did not significantly differ from those one year postoperatively (p=0.46).
CONCLUSIONS
Inferior oblique muscle anteriorization leads to a significant and sustained improvement of ocular alignment in patients with congenital superior oblique palsy of various degrees of severity. Thus the procedure is recommendable as a first line treatment in this clinical situation.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1055/s-0034-1368234
- PMID 24771174
- Persistent URL
- https://sonar.ch/global/documents/253899
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