Disinsertion-distal myectomy and tucking of inferior oblique combined with superior oblique full tendon advancement in superior oblique palsy.

PURPOSE

To assess the preliminary outcomes of inferior oblique (IO) disinsertion-distal myectomy and tucking combined with superior oblique (SO) full tendon advancement in patients with Knapp II or III superior oblique palsy.

METHODS

This single-centered retrospective study included 16 eyes from 13 patients with Knapp Class II or III SO palsy. All patients underwent IO disinsertion-distal myectomy and tucking combined with SO full tendon advancement while under general anesthesia. Pre- and post-operative levels of vertical deviation in the primary position, abnormal head position, IO hyperfunction and SO hypofunction, torsion, as well as the presence of diplopia, were all measured, and the differences were statistically compared.

RESULTS

Pre-operatively, 12 patients had abnormal head positions, and two had diplopia. The pre-and post-operative levels of IO hyperfunction and SO hypofunction, as well as a vertical deviation in the primary position and torsion, all differed statistically significantly (p < 0.01).

CONCLUSIONS

Inferior oblique disinsertion distal myectomy and tucking combined with SO full tendon advancement surgery appears to be an effective procedure in patients with congenital and acquired Knapp Class II or III SO palsy.