Effect of inferior oblique recession in cases of superior oblique palsy

Allam, Ghada Hassan; El-Zeini, Rasha Magdi; Kasem, Manal Ali; Sprunger, Derek; El-Adawe, Ibrahim Taha

doi:10.21608/ejomos.2022.118654.1051

Effect of inferior oblique recession in cases of superior oblique palsy

Document Type : Original Articles

Authors

¹ Department of ophthalmology, Faculty of medicine, Mansoura University, Mansoura, Egypt

² Mansoura Ophthalmic Center, Mansoura University

³ Department of ophthalmology, School of Medicine - Indiana University - United States of America

10.21608/ejomos.2022.118654.1051

Abstract

Purpose:
To evaluate inferior oblique recession as a primary surgical procedure for treatment of superior oblique palsy.
Setting:
Mansoura Ophthalmic Center, Mansoura University, Mansoura, Egypt.
Methods:
Prospective, interventional study comprised 25 patients diagnosed as superior oblique palsy. Complaint was assessed preoperatively & postoperatively e.g., Abnormal head posture, diplopia & cosmetically unaccepted vertical deviation. Vertical deviation in primary position was measured by alternate prism-cover test preoperatively, at 1 week, 3 months and 6 months postoperatively. Inferior oblique overaction was assessed preoperatively & postoperatively. All patients underwent IO recession as a primary surgery for treatment of SOP. Successful outcome was defined as hypertropia of 5 prism diopters (PD) or less in primary position.
Results:
The study comprised 25 patients who underwent IO recession for treatment of SOP. the median age at the time of surgery was 16 years (range 2 to 50 years) comprising 12 males (48%) and 13 females (52%). AHP was found in 21 patients (84%) preoperatively which was improved in 17 patients postoperatively. Postoperative IOOA (grades +2 or more) was considered residual IOOA which was found in 4 patients. Hypotropia in adduction (IO under action) was found in 1 patient. The median hypertropia in primary position decreased significantly postoperatively (P=≤0.001*). There was overcorrection in one patient. The successful outcome was found in 84% (21 of 25 patients).
Conclusion:
Single standardized, nongraded recession of ipsilateral IO was effective in reducing vertical deviation in primary position in cases of SOP & improving AHP & diplopia without creation of new symptoms.

Keywords