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KMID : 0360220140550111674
Journal of the Korean Ophthalmological Society
2014 Volume.55 No. 11 p.1674 ~ p.1680
Clinical Manifestations and Surgical Outcomes of Double Elevator Palsy
Park Hyun-Ju

Lee Jong-Bok
Rhiu Soolienah
Abstract
Purpose: To evaluate the clinical manifestations of double elevator palsy and describe the surgery outcomes in patients.

Methods: We performed a retrospective chart review of all patients who were treated surgically for double elevator palsy between 1999 and 2012 at Yonsei University, Severance Hospital in Seoul, Korea.

Results: Overall, 15 subjects (7 males and 8 females) with a mean age of 14.6 years (range, 3-40 years) underwent their first surgery during the study period. All patients received inferior rectus recession as a primary procedure. Nine patients (60.0%) underwent a secondary procedure which included 4 cases of horizontal muscle transposition, 2 cases of correction of exotropia, and 3 cases of correction of hypotropia and exotropia simultaneously. The mean preoperative hypotropia was decreased from 29.9 ¡¾ 8.4 prism diopter (PD) to 4.7 ¡¾ 5.3 PD postoperatively. Mean follow-up period was 40.9 ¡¾ 48.2 months. Seven patients (46.7%) underwent eyelid surgery for true ptosis. At last follow-up, a majority of patients showed mild or no amblyopia.

Conclusions: Primary inferior rectus recession and additive secondary horizontal muscle transposition surgery was effective in treatment of double elevator palsy. The clinical manifestations and surgical outcomes of monocular elevation deficiency in the present study can help in the treatment of Korean patients.
KEYWORD
Double elevator palsy, Hypotropia, Inferior rectus recession, Muscle transposition
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