Surgical treatment of superior oblique palsy: Predictors of outcome



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Merino Sanz, Pilar and Escribano Villafruela, José and Gómez de Liaño, Pilar and Yela, Rubén (2017) Surgical treatment of superior oblique palsy: Predictors of outcome. Indian Journal of Ophthalmology, 65 (8). pp. 723-728. ISSN 0301-4738; 1998-3689 (e)

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Purpose: The purpose of this study was to evaluate the incidence and outcome of surgically treated superior oblique palsy (SOP) and the factors involved in its resolution.
Methods: We performed a retrospective study of 76 patients who underwent surgery for SOP. We recorded data from the physical examination and the number and type of procedures performed. Favorable outcome was defined as resolution of or improvement in torticollis (≤5°) and diplopia in primary position (PP) and downgaze or as vertical deviation (VD) <5 prism diopters (pd) in PP and 10 pd in the oblique diagnostic position.
Results: Mean age was 33.12 years. Congenital SOP was the most frequent type (65.8%). Mean preoperative VD was 15.89 ± 9.94 pd, decreasing to 3.07 ± 4.36 pd after surgery. Associated horizontal deviation was recorded in 51.32% of cases. The mean number of procedures was 1.37 ± 0.62 (range 1–4), with 69.7% of patients requiring only one procedure. The mean number of muscles operated on was 1.96 ± 1.01 (inferior oblique being the most frequent). A greater reduction in VD after surgery was observed in patients with congenital SOP (P = 0.04). Although none of the factors evaluated influenced surgical outcome, amblyopic patients had a greater risk of reoperation (P = 0.04). A favorable outcome was achieved in 75% of cases. Mean follow‑up was 37.08 months.
Conclusion: Congenital SOP was twice as frequent as acquired SOP and although surgery was successful in most cases, a greater reduction in VD was obtained in congenital cases. Amblyopia was identified as a risk factor for reoperation.

Item Type:Article
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Manuscript received: 05.09.16; Revision accepted: 30.06.17

Uncontrolled Keywords:Acquired superior oblique palsy; Amblyopia; Congenital superior oblique palsy; Multiple surgeries; Surgical treatment
Subjects:Medical sciences > Medicine > Surgery
Medical sciences > Medicine > Ophtalmology
ID Code:65491
Deposited On:29 May 2021 09:43
Last Modified:31 May 2021 07:59

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