Torrado Laura A, Brodsky Michael C
a Department of Ophthalmology , Mayo Clinic , Rochester , Minnesota.
b Neurology , Mayo Clinic , Rochester , Minnesota.
J Binocul Vis Ocul Motil. 2019 Jan-Mar;69(1):8-12. doi: 10.1080/2576117X.2018.1554931. Epub 2019 Jan 7.
To evaluate the effects of isolated inferior oblique (IO) muscle recession in patients with superior oblique palsy (SOP) and persistent hypertropia in abduction.
Retrospective review of patients with unilateral SOP who were treated with isolated IO recession by a single surgeon (MCB) between January 2008 and December 2017. We included patients with congenital and acquired fourth nerve palsies, with a hyperdeviation of less than 20 prism diopters in primary position and at least 4 prism diopters in abduction by prism and alternate cover test (PACT) during distance fixation. A minimum follow-up of 4-6 weeks was required. Age at surgery, etiology, presence of head tilt, motor alignment in primary and secondary gaze positions at distance and near using PACT, versions, ductions, and torsion were recorded from the patients' chart.
Seven patients with SOP were included in this study. Four (57.14%) males, with a mean age at presentation of 41.86 years (range: 6-66 years). Mean follow-up was 13.25 months (range: 1.3-52.2 months). A decrease in mean central gaze hypertropia from 11.4 to 1.71 PD was found. A mean contralateral gaze hypertropia that decreased from 22.28 to 5.71 PD and an ipsilateral gaze hypertropia that improved from 5.86 to 1.14 PD were also noted. Torsion had a mean change of 3.4° of incyclodeviation at the final examination.
This study confirms the efficacy of isolated maximal IO recession for the treatment of unilateral SOP that is accompanied by a modest hypertropia of the paretic eye in abduction.
评估孤立性下斜肌（IO）后徙术对患眼上斜肌麻痹（SOP）且外展时持续性上斜视患者的疗效。
回顾性分析2008年1月至2017年12月间由同一位外科医生（MCB）采用孤立性IO后徙术治疗的单侧SOP患者。纳入先天性和后天性动眼神经麻痹患者，采用三棱镜交替遮盖试验（PACT），原在位垂直斜视度小于20棱镜度，远距离注视外展时垂直斜视度至少4棱镜度。要求至少随访4 - 6周。从患者病历中记录手术年龄、病因、头位倾斜情况、使用PACT法测量的远距离和近距离原在位及第二注视位的眼位、转位、转导和旋转情况。
本研究纳入7例SOP患者。4例（57.14%）为男性，就诊时平均年龄41.86岁（范围：6 - 66岁）。平均随访13.25个月（范围：1.3 - 52.2个月）。发现中央注视位平均上斜视度从11.4棱镜度降至1.71棱镜度。还注意到对侧注视位平均上斜视度从22.28棱镜度降至5.71棱镜度，同侧注视位上斜视度从5.86棱镜度改善至1.14棱镜度。最终检查时旋转平均变化为3.4°内旋斜视。
本研究证实孤立性最大程度IO后徙术治疗伴有患眼外展时轻度上斜视的单侧SOP的有效性。
