Journal of the Korean Ophthalmological Society 2007;48(3):418-422.
Published online March 31, 2007.
Characteristics and Outcome in Horizontal Strabismus Combined with Unilateral Superior Oblique Palsy.
Sung Won Choi, Se Hwan Jung, Sang Hoon Rah
Department of Ophthalmology, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea. shrah@yonsei.ac.kr
단안 상사근 마비와 동반된 수평 사시의 특징 및 치료 예후
최성원,정세환,라상훈
Department of Ophthalmology, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
Correspondence:  Sung Won Choi, M.D.
Abstract
PURPOSE
To review the clinical characteristics and treatment outcomes in horizontal strabismus combined with unilateral superior oblique palsy (SOP). METHODS: A retrospective review of medical records was conducted in 21 patients with unilateral SOP treated between January 2001 and December 2005. Patients had more than 6 months of follow-up at the Department of Ophthalmology, Wonju College of Medicine. RESULTS: Among 21 patients (11 male, 10 female) with unilateral SOP, 57.1% of patients had horizontal strabismus. The mean vertical deviation was 12.56+/-3.81 (8~24) PD. All patients with horizontal strabismus had exotropia and the mean deviation was 10.57+/-4.58 (6~20) PD. A standard 10mm inferior oblique (IO) recession was performed uniformly at the paretic eye in all patients. In 7 of the patients (58.3%, exotropia greater than or equal to 10PD), horizontal rectus muscle recession was performed simultaneously. In these 7 cases, vertical and horizontal deviation less than or equal to 4PD was achieved (one patient with 10PD remaining hypertropia excluded). In 5 cases with exodeviation less than 10PD, isolated IO recession without horizontal rectus recession on the ipsilateral side achieved orthophoria in the primary position. In 9 cases of isolated SOP, all patients showed orthophoria in the primary position. CONCLUSIONS: This study demonstrates horizontal strabismus is combined with unilateral SOP in a high percentage of patients. Additionally, in all cases, all the incidents of horizontal deviation was involved exotropia. A standard 10 mm recession of the IO in combination with horizontal rectus recession is an effective surgical technique. It has an especially high success rate in patients with unilateral SOP (< or =14PD vertical deviation) with exodeviation greater than 10PD. In patients with exodeviation less than 10PD, an isolated IO recession is sufficiently effective.
Key Words: Horizontal strabismus;Isolated recession of inferior oblique muscle;Superior oblique palsy


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