Session: Poster session B
Surgical techniques and their outcomes in the treatment of congenital or acquired superior oblique muscle palsy
Introduction:Paralysis of the superior oblique muscle is the most frequent cause of vertical strabismus and the most frequent form of oculomotor paralysis seen in children. The condition is most often congenital but can also be acquired. In certain severe cases, surgery should be proposed.
Objectives:Describe the characteristics of patients who have undergone surgery for superior oblique palsy. Describe the most commonly performed surgical interventions with their outcomes.Methods: Data from 45 patients who have undergone a first surgery for superior oblique palsy between 2010 and 2022 was collected. The procedures were performed at the University Hospital of Bordeaux or the University Hospital of Tours. Data was collected during the last preoperative consultation and six months post-surgery.
Results: Inferior oblique recession was the chosen procedure in 41% of cases. The average inferior oblique recession was 8,2mm. 27% of patients had inferior oblique recession and superior oblique tuck. The average vertical deviation in distance vision before surgery was 13,5 diopters. The average vertical deviation in distance vision after surgery was 4,75 diopters. Preoperatively, 88% of patients had torticollis, 70% of patients had notable excyclotorsion, 53% suffered from diplopia and 23% had prismation.These percentages were respectively reduced to 50%, 38%, 17% and 14% after the first surgery. 69% of patients reported being satisfied after a first surgery.
Conclusion: Recession of the inferior oblique muscle is the most commonly used surgical procedure. One-third of patients undergo a combined procedure involving both the inferior and superior oblique muscles. Following the initial surgery, vertical deviation is reduced by 70 percent from the first measurement. A significant improvement in symptoms (torticollis, diplopia, excyclotorsion) is observed postoperatively and results are predominantly satisfactory from the patient's perspective.
Objectives:Describe the characteristics of patients who have undergone surgery for superior oblique palsy. Describe the most commonly performed surgical interventions with their outcomes.Methods: Data from 45 patients who have undergone a first surgery for superior oblique palsy between 2010 and 2022 was collected. The procedures were performed at the University Hospital of Bordeaux or the University Hospital of Tours. Data was collected during the last preoperative consultation and six months post-surgery.
Results: Inferior oblique recession was the chosen procedure in 41% of cases. The average inferior oblique recession was 8,2mm. 27% of patients had inferior oblique recession and superior oblique tuck. The average vertical deviation in distance vision before surgery was 13,5 diopters. The average vertical deviation in distance vision after surgery was 4,75 diopters. Preoperatively, 88% of patients had torticollis, 70% of patients had notable excyclotorsion, 53% suffered from diplopia and 23% had prismation.These percentages were respectively reduced to 50%, 38%, 17% and 14% after the first surgery. 69% of patients reported being satisfied after a first surgery.
Conclusion: Recession of the inferior oblique muscle is the most commonly used surgical procedure. One-third of patients undergo a combined procedure involving both the inferior and superior oblique muscles. Following the initial surgery, vertical deviation is reduced by 70 percent from the first measurement. A significant improvement in symptoms (torticollis, diplopia, excyclotorsion) is observed postoperatively and results are predominantly satisfactory from the patient's perspective.