The Clinical Course of Superior Oblique Tuck Surgery in Patients with Unilateral Superior Oblique Palsy

Hyun Ji Hwang; Dong Hyun Kang; Ungsoo Samuel Kim; Seung-Hee Baek

doi:10.3341/jkos.2019.60.10.982

Journal List > J Korean Ophthalmol Soc > v.60(10) > 1135393

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Hwang, Kang, Kim, and Baek: The Clinical Course of Superior Oblique Tuck Surgery in Patients with Unilateral Superior Oblique Palsy

Original Article

Journal of the Korean Ophthalmological Society 2019; 60(10): 982-989.

Published online: 21 October 2019

DOI: https://doi.org/10.3341/jkos.2019.60.10.982

The Clinical Course of Superior Oblique Tuck Surgery in Patients with Unilateral Superior Oblique Palsy

Hyun Ji Hwang, MD, Dong Hyun Kang, MD, Ungsoo Samuel Kim, MD, Seung-Hee Baek, MD, PhD

Myung-Gok Eye Research Institute, Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea.

Address reprint requests to Seung-Hee Baek, MD, PhD. Kim's Eye Hospital, #136 Yeongsin-ro, Yeongdeungpo-gu, Seoul 07301, Korea. Tel: 82-2-2639-7812, Fax: 82-2-2639-6359, drslitlamp@kimeye.com

Received 15 November 2018 Revised 1 March 2019 Accepted 24 September 2019

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the effects of surgery depending on the follow-up duration after superior oblique tuck was performed as the first surgery in unilateral superior oblique palsy patients.

Methods

Sixteen patients who were followed-up for a minimum of 3 months were retrospectively evaluated. The vertical deviation, abnormal head posture, superior oblique underaction, and inferior oblique overaction were evaluated before and at 3, 6, and 12 months after the surgery and at the last follow-up. The angle between the center of the optic disc and fovea (disc-fovea angle) was measured using fundus photography to investigate changes in ocular torsion.

Results

The mean follow-up period was 24.9 ± 21.9 months and the mean tuck was 11.4 ± 4.0 mm. Vertical deviation <7 prism diopters in the primary position was observed in 53.9% of patients at 3 months postoperatively, 50.0% at 6 months, 83.3% at 12 months, and 62.5% at the last follow-up (p = 0.55). Head posture was improved in 66.7% of patients at 3 months, 71.4% at 6 months, 50% at 12 months, and 80% at the last follow-up after surgery (p = 0.73). Ocular torsion was decreased in 37.5% of patients at 3 months postoperatively, 66.7% at 6 months, 75% at 12 months, and 80.0% at the last follow-up (p = 0.11). Superior oblique underaction was improved in 100%, 77.8%, 60%, and 75% of the patients and inferior oblique overaction was improved in 100%, 88.9%, 85.7%, and 81.3% of the patients at postoperative month 3, 6, and 12, and at the last follow-up, respectively.

Conclusions

Superior oblique tuck resulted in the maintenance of an improved condition of patients at 3, 6, and 12 months postoperatively, and there was no significant difference in motor measurements between the follow-up periods.

Keywords: Superior oblique palsy, Superior oblique tuck surgery

Figures and Tables

Figure 1

Table 1

Baseline characteristics of patients with unilateral superior oblique palsy

All cases are presumably congenital (n = 16). Values are presented as mean ± standard deviation or number (%) unless otherwise indicated.

OD = oculus dexter; OS = oculus sinister; PD = prism diopters; SO = superior oblique; IO = inferior oblique; IR = inferior rectus; SR = superior rectus.

Table 2

Vertical deviations and foveal torsions during the follow-up of superior oblique tuck surgery in unilateral SOP patients

Values are presented as mean ± standard deviation.

SOP = superior oblique palsy; POD = postoperative; m = months; PD = prism diopters.

Table 3

Surgical results of each parameters during the follow-up after superior oblique tuck surgery in unilateral SOP patients

Values are presented as %.

SOP = superior oblique palsy; POD = postoperative; m = months; PD = prism diopters; SOUA = superior oblique underaction; IOOA = inferior oblique overaction.

^*Chi-square test.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

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