A single inferior rectus muscle surgery for treatment of congenital superior oblique palsy with small deviation in primary position

Abstract

Purpose:

To evaluate outcomes of one muscle surgery for treatment of congenital superior oblique palsy (SOP) with Knapp Class V.

Methods:

Medical records were retrospectively reviewed for the patients with the congenital SOP type V who underwent surgical treatment through one muscle surgery between July 2015 and September 2020. The surgical procedure was resection-recession on the contralateral inferior rectus muscle of the hypertrophic or paretic eye. Vertical alignment at nine cardinal gaze positions, and resolution of the abnormal head posture were evaluated pre- and postoperatively. The follow-up was scheduled regularly at postoperative day 1, 1 week, 1 month, and followed by 2-month intervals until 18 months.

Results:

Twelve patients were included in this study, with a mean age of 6.4 years (range from 3 to 10 years). The mean follow-up period was 10.5 months after surgery (range from 6 to 18 months). The average vertical deviation at primary position was 6.33^△ ± 2.93^△ preoperatively and 0.75^△ ± 1.14^△ postoperatively (p < 0.05). The average vertical deviation at downgaze was 23.33^△ ± 4.75^△ preoperatively and 1.92^△ ± 1.62^△ postoperatively (p < 0.05). All patients had an abnormal head position preoperatively. Postoperative results indicated that the patients’ abnormal head position had been improved significantly.

Conclusions:

The surgical procedure of resection-recession on a single inferior rectus muscle is a successful intervention for the correction of superior oblique palsy (SOP) with Knapp Class V.

Keywords

SOP Knapp Class V Scott treatment resection-recession

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