Huang Lijuan, Yan Honggai, Xie Yan, Li Ningdong
Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China.
Indian J Ophthalmol. 2024 Dec 1;72(12):1761-1765. doi: 10.4103/IJO.IJO_3257_23. Epub 2024 Jul 11.
To evaluate the surgical outcomes for patients with superior oblique paralysis (SOP) who underwent the inferior oblique weakening and the graded partial inferior rectus muscle tenotomy in the contralateral eye.
Medical records were retrospectively reviewed for those SOP patients who had hyperdeviation of 4 △ -20 △ in the primary position and 8 △ -25 △ in the downgaze position. Patients were subdivided into three subgroups according to their vertical deviation angle in the downgaze position. They underwent an ipsilateral inferior oblique muscle recession and a graded partial tenotomy of the contralateral inferior rectus muscle. The vertical deviation angles, abnormal head position, and fundus torsion were compared statistically before and after operations. All patients were followed up at least 1 year.
Forty-seven patients were included in this study. The mean follow-up period was 17.2 months after surgery (ranging from 12 to 28 months). The vertical deviation angle was averaged preoperatively to 7.74 △ ± 3.23 △ in the primary position and 15.30 △ ± 5.92 △ in the downgaze position and reduced postoperatively to 0.85 △ ± 1.15 △ in the primary position and 1.53 △ ± 1.49 △ in the downgaze position ( P < 0.001). All patients had an abnormal head position preoperatively and had improved significantly postoperatively. Fundus extorsion had been improved significantly postoperatively.
The surgical procedure of IO weakening combined with contralateral graded partial inferior rectus muscle tenotomy is a successful intervention for the correction of small deviation in primary position of SOP.
评估接受患眼下斜肌减弱术和对侧眼分级部分下直肌切断术的上斜肌麻痹（SOP）患者的手术效果。
回顾性分析那些在第一眼位垂直斜视度为4△ - 20△、下视位垂直斜视度为8△ - 25△的SOP患者的病历。根据患者下视位的垂直斜视角度将其分为三个亚组。他们接受了患眼下斜肌后徙术和对侧眼下直肌分级部分切断术。对手术前后的垂直斜视角度、异常头位和眼底扭转情况进行统计学比较。所有患者均随访至少1年。
本研究纳入47例患者。术后平均随访时间为17.2个月（12至28个月）。第一眼位垂直斜视角度术前平均为7.74△ ± 3.23△，下视位为15.30△ ± 5.92△，术后分别降至0.85△ ± 1.15△和1.53△ ± 1.49△（P < 0.001）。所有患者术前均有异常头位，术后明显改善。术后眼底外旋明显改善。
下斜肌减弱联合对侧分级部分下直肌切断术是矫正SOP第一眼位小度数斜视的成功干预方法。
