Department of Ophthalmology, The Second People's Hospital of Jinan, No. 148 Jingyi Road, Jinan, 250000, China.
Int Ophthalmol. 2024 Aug 5;44(1):342. doi: 10.1007/s10792-024-03261-z.
Evaluate and analyze the efficacy of inferior oblique belly transposition (IOBT) in treating adult patients with diplopia and small-angle hypertropia caused by mild to moderate inferior oblique overaction (IOOA) secondary to acquired superior oblique palsy (SOP).
Nine adult patients with diplopia and small-angle hypertropia associated with mild to moderate IOOA secondary to unilateral acquired SOP were included in the current retrospective study. All patients received the IOBT procedure between February 2019 and May 2023 at The Second People's Hospital of Jinan and were followed up for more than 6 months after the surgery. During the procedure, the belly of the inferior oblique muscle was fixed to the sclera at 5 mm posterior to the temporal insertion of the inferior rectus muscle. The following indicators were reviewed pre- and post-surgery: the vertical deviation (VD) in the primary position and in the Bielschowsky test, the fovea disc angle (FDA) of the affected eye, changes in IOOA, and diplopia.
After IOBT, the VD in the primary position decreased from 7.22 ± 1.72 (range 4-10) to 1.22 ± 1.30 (range 0-3). The VD in the Bielschowsky test decreased from 13.00 ± 1.80 to 3.22 ± 1.09. The FDA decreased from 10.02° ± 3.34° to 6.26° ± 1.91°. The grade of IOOA was reduced from 2.00 (1.00, 2.00) to 0.00 (0.00, 1.00). All changes were statistically significant (P < 0.001 or P = 0.006). Diplopia was resolved completely for all patients.
IOBT can effectively treat adults with diplopia and small-angle hypertropia caused by mild to moderate IOOA secondary to acquired SOP.
评估和分析下斜肌腹移位术（IOBT）治疗因后天性上斜肌麻痹（SOP）导致的轻度至中度下斜肌亢进（IOOA）继发的成人复视和小角度斜视的疗效。
本回顾性研究纳入了 9 例因后天性 SOP 导致的单侧上斜肌麻痹而继发轻度至中度 IOOA 伴复视和小角度斜视的成年患者。所有患者均于 2019 年 2 月至 2023 年 5 月在济南市第二人民医院接受 IOBT 手术，并在手术后随访超过 6 个月。手术过程中，将下斜肌的肌腹固定在距下直肌颞侧止点后 5mm 的巩膜上。手术前后评估以下指标：第一眼位垂直偏斜（VD）和贝尔氏试验垂直偏斜、患眼黄斑中心凹角度（FDA）、IOOA 变化和复视。
IOBT 后，第一眼位 VD 从 7.22±1.72（范围 4-10）降至 1.22±1.30（范围 0-3）。贝尔氏试验垂直偏斜从 13.00±1.80 降至 3.22±1.09。FDA 从 10.02°±3.34°降至 6.26°±1.91°。IOOA 分级从 2.00（1.00，2.00）降至 0.00（0.00，1.00）。所有变化均具有统计学意义（P<0.001 或 P=0.006）。所有患者的复视均完全消失。
IOBT 可有效治疗因后天性 SOP 导致的轻度至中度 IOOA 继发的成人复视和小角度斜视。
