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KMID : 0360220070480030418
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Journal of the Korean Ophthalmological Society
2007 Volume.48 No. 3 p.418 ~ p.422
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Characteristics and Outcome in Horizontal Strabismus Combined with Unilateral Superior Oblique Palsy
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Choi Sung-Won
Jung Se-Hwan
Rah Sang-Hoon
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Abstract
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Purpose: To review the clinical characteristics and treatment outcomes in horizontal strabismus combined with unilateral superior oblique palsy (SOP).
Methods: A retrospective review of medical records was conducted in 21 patients with unilateral SOP treated between January 2001 and December 2005. Patients had more than 6 months of follow-up at the Department of Ophthalmology, Wonju College of Medicine.
Results: Among 21 patients (11 male, 10 female) with unilateral SOP, 57.1% of patients had horizontal strabismus. The mean vertical deviation was 12.56±3.81 (8~24) PD. All patients with horizontal strabismus had exotropia and the mean deviation was 10.57±4.58 (6~20) PD. A standard 10mm inferior oblique (IO) recession was performed uniformly at the paretic eye in all patients. In 7 of the patients (58.3%, exotropia greater than or equal to 10PD), horizontal rectus muscle recession was performed simultaneously. In these 7 cases, vertical and horizontal deviation less than or equal to 4PD was achieved (one patient with 10PD remaining hypertropia excluded). In 5 cases with exodeviation less than 10PD, isolated IO recession without horizontal rectus recession on the ipsilateral side achieved orthophoria in the primary position. In 9 cases of isolated SOP, all patients showed orthophoria in the primary position.
Conclusions: This study demonstrates horizontal strabismus is combined with unilateral SOP in a high percentage of patients. Additionally, in all cases, all the incidents of horizontal deviation was involved exotropia. A standard 10 mm recession of the IO in combination with horizontal rectus recession is an effective surgical technique. It has an especially high success rate in patients with unilateral SOP (≤14PD vertical deviation) with exodeviation greater than 10PD. In patients with exodeviation less than 10PD, an isolated IO recession is sufficiently effective. J Korean Ophthalmol Soc 48(3):418-422, 2007
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KEYWORD
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Horizontal strabismus, Isolated recession of inferior oblique muscle, Superior oblique palsy
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