Inferior oblique muscle recession with and without superior oblique tendon tuck for treatment of unilateral congenital superior oblique palsy

Purpose: To compare the surgical results in patients with congenital superior oblique palsy treated with inferior oblique recession (IOR) versus those treated additionally with superior oblique tendon tuck (IOR+SOT). Methods: A consecutive, nonrandomized series of patients with congenital superior o...

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Hauptverfasser: Kaeser, Pierre-François (VerfasserIn) , Klainguti, Georges (VerfasserIn) , Kolling, Gerold (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 25 February 2012
In: Journal of the American Association for Pediatric Ophthalmology and Strabismus
Year: 2012, Jahrgang: 16, Heft: 1, Pages: 26-31
ISSN:1528-3933
DOI:10.1016/j.jaapos.2011.08.012
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1016/j.jaapos.2011.08.012
Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S1091853112000080
Volltext
Verfasserangaben:Pierre-François Kaeser, Georges Klainguti, Gerold H. Kolling

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520 |a Purpose: To compare the surgical results in patients with congenital superior oblique palsy treated with inferior oblique recession (IOR) versus those treated additionally with superior oblique tendon tuck (IOR+SOT). Methods: A consecutive, nonrandomized series of patients with congenital superior oblique palsy with vertical deviations in adduction between 10° and 20° were retrospectively reviewed. In the first series, patients were treated with IOR; in the second series, patients were treated with IOR+SOT. We examined the effects of surgery on binocular alignment and on the field of binocular single vision. Results: Each group consisted of 20 patients. Preoperative ocular deviations were similar in both groups. Postoperative residual vertical deviations were not different in the primary position or in downgaze; however, significantly better alignment was achieved in the IOR+SOT group in adduction and downgaze in adduction. Consecutive Brown pattern occurred in 18 of 20 patients who underwent IOR+SOT versus 5 of 20 who underwent IOR. Residual torsion was not statistically different. The field of binocular single vision improved to 92% (range, 28%-100%) after IOR and to 96% (range, 64%-100%) after IOR+SOT (P = 0.20). Conclusions: IOR alone is a suitable procedure for most congenital superior oblique palsies with a moderate-to-large vertical deviation in adduction, resulting in a lower incidence of consecutive Brown pattern than with IOR+SOT. 
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