Farvardin Hajar, Ebrahimi Fatemeh, Farvardin Hadi, Farvardin Majid
Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Strabismus. 2025 Mar;33(1):13-19. doi: 10.1080/09273972.2024.2401439. Epub 2024 Sep 19.
To compare the surgical outcomes of One- versus Two-vertical muscle surgery in patients with unilateral superior oblique muscle palsy (SOP) with primary position hypertropia (HT) over 20 PD. Patients in Group 1 underwent inferior oblique anterior transposition plus resection (IOATR), while patients in Group 2 underwent inferior oblique anterior transposition (IOAT) along with contralateral inferior rectus (IR) recession. Medical data of all SOP patients treated by either procedure from 2000 to 2023 in our strabismus center were recruited. We compared surgical outcomes between Group 1 and Group 2 by analyzing HT correction, rate of under-correction, and over-correction. The study included 33 patients in Group 1 and 23 in Group 2. Both groups were similar in age, sex, etiology, affected side, diplopia, and head tilt. Group 2 achieved higher HT correction in all measured gazes. Group 1 had a higher risk of under-correction (18.18% in Group 1 vs 8.69% in Group 2) while Group 2 had a higher rate of over-correction (21.73% vs 0% in Group 1). In patients with severe unilateral SOP, Two-vertical muscle surgery achieved higher amounts of HT correction in all gazes despite a significantly higher risk of over-correction.
比较单眼上斜肌麻痹（SOP）且原在位垂直斜视（HT）超过20棱镜度（PD）的患者行单垂直肌手术与双垂直肌手术的手术效果。第1组患者接受下斜肌前徙转位联合切除术（IOATR），而第2组患者接受下斜肌前徙转位（IOAT）联合对侧下直肌（IR）后徙术。收集了2000年至2023年在我们斜视中心接受这两种手术治疗的所有SOP患者的医学数据。我们通过分析HT矫正情况、欠矫率和过矫率来比较第1组和第2组的手术效果。该研究包括第1组的33例患者和第2组的23例患者。两组在年龄、性别、病因、患侧、复视和头位倾斜方面相似。第2组在所有测量注视方向上的HT矫正效果更好。第1组的欠矫风险更高（第1组为18.18%，第2组为8.69%），而第2组的过矫率更高（第2组为21.73%，第1组为0%）。在重度单眼SOP患者中，双垂直肌手术在所有注视方向上的HT矫正量更高，尽管过矫风险显著更高。
