J Korean Ophthalmol Soc > Volume 55(11); 2014 > Article
Journal of the Korean Ophthalmological Society 2014;55(11):1674-1680.
DOI: https://doi.org/10.3341/jkos.2014.55.11.1674    Published online November 15, 2014.
Clinical Manifestations and Surgical Outcomes of Double Elevator Palsy.
Hyun Ju Park, Jong Bok Lee, Soolienah Rhiu
1Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
2Department of Ophthalmology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea. soolienah99@naver.com
양상전근 마비의 임상 양상 및 수술 결과
박현주1⋅이종복1⋅유수리나2
Department of Ophthalmology, Yonsei University College of Medicine1, Seoul, Korea
Department of Ophthalmology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine2, Hwaseong, Korea
Abstract
PURPOSE
To evaluate the clinical manifestations of double elevator palsy and describe the surgery outcomes in patients. METHODS: We performed a retrospective chart review of all patients who were treated surgically for double elevator palsy between 1999 and 2012 at Yonsei University, Severance Hospital in Seoul, Korea. RESULTS: Overall, 15 subjects (7 males and 8 females) with a mean age of 14.6 years (range, 3-40 years) underwent their first surgery during the study period. All patients received inferior rectus recession as a primary procedure. Nine patients (60.0%) underwent a secondary procedure which included 4 cases of horizontal muscle transposition, 2 cases of correction of exotropia, and 3 cases of correction of hypotropia and exotropia simultaneously. The mean preoperative hypotropia was decreased from 29.9 +/- 8.4 prism diopter (PD) to 4.7 +/- 5.3 PD postoperatively. Mean follow-up period was 40.9 +/- 48.2 months. Seven patients (46.7%) underwent eyelid surgery for true ptosis. At last follow-up, a majority of patients showed mild or no amblyopia. CONCLUSIONS: Primary inferior rectus recession and additive secondary horizontal muscle transposition surgery was effective in treatment of double elevator palsy. The clinical manifestations and surgical outcomes of monocular elevation deficiency in the present study can help in the treatment of Korean patients.
Key Words: Double elevator palsy;Hypotropia;Inferior rectus recession;Muscle transposition


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