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Does inferior oblique recession cause overcorrections in laterally incomitant small hypertropias due to superior oblique palsy?
  1. Karen Hendler1,
  2. Stacy L Pineles1,
  3. Joseph L Demer1,
  4. Arthur L Rosenbaum1,
  5. Guillermo Velez2,
  6. Federico G Velez1,3
  1. 1Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, California, USA
  2. 2Department of Ophthalmology, University of Antioquia—Private practice, Medellin, Colombia
  3. 3Department of Surgery, Division of Pediatric Ophthalmology, Olive View-UCLA Medical Center, Sylmar, California, USA
  1. Correspondence to
    Dr Federico G Velez, Department of Surgery, Division of Pediatric Ophthalmology, Olive View-UCLA Medical Center, 100 Stein Plaza, Los Angeles, CA 90095, USA; velez{at}jsei.ucla.edu

Abstract

Aim To evaluate the effects of inferior oblique muscle recession (IOR) in cases of laterally incomitant hypertropia <10 prism dioptres (PD) in central gaze thact 2t are clinically consistent with superior oblique palsy (SOP).

Methods We retrospectively reviewed patients with SOP and hypertropias <10 PD in central gaze who underwent graded IOR. Primary outcomes were reduction of lateral incomitance and number of overcorrections in central gaze.

Results Twenty-five patients were included. Mean follow-up was 13.8 months (range 1.4–66). Mean central gaze hypertropia decreased from 5.6±2.1 to 0.2±1.6 PD (p<0.001). Contralateral gaze hypertropia decreased from 15.9±7.6 to 2.3±3.3 PD (p<0.001). Lateral incomitance (central vs contralateral gaze) was 10.3±6.9 PD preoperatively and 2.0±3.0 PD postoperatively (p<0.001). There were two patients overcorrected in central gaze, and one patient overcorrected in downgaze. One patient necessitated further surgery for overcorrection.

Conclusions Although small hypertropias can be treated with prisms or small, adjustable inferior rectus recessions, IOR collapses incomitance without causing much overcorrection. IOR is a reasonable treatment for small, laterally incomitant hypertropia due to SOP.

  • Muscles
  • Treatment Surgery

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