J Korean Ophthalmol Soc > Volume 60(10); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(10):982-989.
DOI: https://doi.org/10.3341/jkos.2019.60.10.982    Published online October 15, 2019.
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
Myung-Gok Eye Research Institute, Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea. drslitlamp@kimeye.com
단안 상사근마비환자에서 시행한 상사근접치기수술의 효과
황현지 · 강동현 · 김응수 · 백승희
건양대학교 의과대학 김안과병원 안과학교실 명곡안연구소
Correspondence:  Seung-Hee Baek, MD, PhD
Email: drslitlamp@kimeye.com
Received: 15 November 2018   • Revised: 1 March 2019   • Accepted: 24 September 2019
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.
Key Words: Superior oblique palsy;Superior oblique tuck surgery


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