Surgical treatment of unilateral acquired superior oblique muscle palsy in adults by inferior oblique belly transposition: a retrospective analysis.

IF 1.4 4区医学 Q3 OPHTHALMOLOGY

International Ophthalmology Pub Date : 2024-08-05 DOI:10.1007/s10792-024-03261-z

Longge Sun, Shanshan Ren, Qian Li, Te Fu, Yuanyuan Guo, Xiaolin Yin

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Abstract

Purpose: Evaluate and analyze the efficacy of inferior oblique belly transposition (IOBT) in treating adult patients with diplopia and small-angle hypertropia caused by mild to moderate inferior oblique overaction (IOOA) secondary to acquired superior oblique palsy (SOP).

Methods: Nine adult patients with diplopia and small-angle hypertropia associated with mild to moderate IOOA secondary to unilateral acquired SOP were included in the current retrospective study. All patients received the IOBT procedure between February 2019 and May 2023 at The Second People's Hospital of Jinan and were followed up for more than 6 months after the surgery. During the procedure, the belly of the inferior oblique muscle was fixed to the sclera at 5 mm posterior to the temporal insertion of the inferior rectus muscle. The following indicators were reviewed pre- and post-surgery: the vertical deviation (VD) in the primary position and in the Bielschowsky test, the fovea disc angle (FDA) of the affected eye, changes in IOOA, and diplopia.

Results: After IOBT, the VD in the primary position decreased from 7.22^△ ± 1.72^△ (range 4^△-10^△) to 1.22^△ ± 1.30^△ (range 0^△-3^△). The VD in the Bielschowsky test decreased from 13.00^△ ± 1.80^△ to 3.22^△ ± 1.09^△. The FDA decreased from 10.02° ± 3.34° to 6.26° ± 1.91°. The grade of IOOA was reduced from 2.00 (1.00, 2.00) to 0.00 (0.00, 1.00). All changes were statistically significant (P < 0.001 or P = 0.006). Diplopia was resolved completely for all patients.

Conclusions: IOBT can effectively treat adults with diplopia and small-angle hypertropia caused by mild to moderate IOOA secondary to acquired SOP.

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通过下斜腹转位手术治疗成人单侧获得性上斜肌麻痹：一项回顾性分析。

目的：评估和分析下斜腹转位术（IOBT）治疗继发于获得性上斜肌麻痹（SOP）的轻中度下斜肌过度作用（IOOA）引起的复视和小角度斜视的成年患者的疗效：本次回顾性研究共纳入了九名继发于单侧获得性上斜肌麻痹的轻度至中度下斜肌过度活动（IOOA）引起复视和小角度斜视的成年患者。所有患者均于2019年2月至2023年5月期间在济南市第二人民医院接受了IOBT手术，术后随访6个月以上。术中，将下斜肌腹部固定在下直肌颞侧插入点后方5毫米处的巩膜上。手术前后对以下指标进行了复查：主要位置和比尔肖夫斯基试验中的垂直偏差（VD）、患眼的眼窝圆盘角（FDA）、IOOA的变化以及复视：IOBT后，主视位的VD从7.22△±1.72△（范围4△-10△）降至1.22△±1.30△（范围0△-3△）。Bielschowsky测试中的VD从13.00△±1.80△降至3.22△±1.09△。FDA从10.02°±3.34°下降到6.26°±1.91°。IOOA 分级从 2.00（1.00，2.00）降至 0.00（0.00，1.00）。所有变化均有统计学意义（P 结论：IOBT 可有效治疗成人 IOOA：IOBT 可有效治疗成人因后天性 SOP 而引起的轻度至中度 IOOA 所导致的复视和小角度斜视。

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来源期刊

International Ophthalmology OPHTHALMOLOGY-

CiteScore

3.20

自引率

0.00%

发文量

451

期刊介绍： International Ophthalmology provides the clinician with articles on all the relevant subspecialties of ophthalmology, with a broad international scope. The emphasis is on presentation of the latest clinical research in the field. In addition, the journal includes regular sections devoted to new developments in technologies, products, and techniques.