A comparative study of the effectiveness of disinsertion and anterior transposition of the inferior oblique in the treatment of unilateral superior oblique palsy

Yanyalı, Ateş; Elibol, Orhan; Talu, Haluk; Karabaş, Levent; Alp, Banu; Çağlar, Yusuf

doi:10.1076/stra.9.2.83.702

Cited by 27 publications

(48 citation statements)

References 19 publications

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“…We screened the remaining 713 reports and obtained five full-text reports for further assessment. We identified two studies that met the inclusion criteria for this review (Shipman 2003; Yanyali 2001), and excluded the remaining three studies (Bahl 2013; Muchnick 1998; Ziffer 1993). Our searches of clinical trials registries did not yield any ongoing studies.…”

Section: Resultsmentioning

confidence: 99%

“…Yanyali 2001 enrolled 22 adults and children with unilateral superior oblique palsy diagnosed based on ipsilateral hypertropia in the primary position that was greater on contralateral gaze and ipsilateral head tilt, in addition to ipsilateral underdepression in adduction (“superior oblique underaction”) and overelevation in adduction (“inferior oblique overaction”). Candidates who had prior extraocular muscle surgery or hypertropia less than 8 PD in primary position were excluded.…”

Section: Resultsmentioning

confidence: 99%

“…Surgical options for hypertropia in superior oblique palsy include: ipsilateral superior oblique tendon plication (’tucking’) (Bhola 2005; Durnian 2011); superior oblique tendon resection and advancement (Luton 1998; Wheeler 1934); procedures to weaken the ipsilateral inferior oblique, including recession (Hendler 2013; Parks 1972), myectomy (Bahl 2013; Lee 2015), myotomy (Lee 2015), marginal myotomy (Mellott 2002), disinsertion (Parks 1972; Yanyali 2001), anterior transposition (Elliott 1981; Farvardin 2002), anterior nasal transposition (Hussein 2007; Stager 2003), and orbital fixation (Ela-Dalman 2007); ipsilateral superior rectus recession (Ahn 2012); and contralateral inferior rectus recession (Mahmoud 2009). …”

Section: Introductionmentioning

confidence: 99%

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Surgical interventions for vertical strabismus in superior oblique palsy

Chang¹,

Coleman²,

Tseng³

et al. 2017

Cochrane Database of Systematic Reviews

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Background Superior oblique palsy is a common cause of vertical strabismus in adults and children. Patients may be symptomatic from binocular vertical diplopia or compensatory head tilt required to maintain single vision. Most patients who are symptomatic elect to undergo strabismus surgery, but the optimal surgical treatment for vertical strabismus in people with superior oblique palsy is unknown. Objectives To assess the relative effects of surgical treatments compared with another surgical intervention, non-surgical intervention, or observation for vertical strabismus in people with superior oblique palsy. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 12), MEDLINE Ovid (1946 to 13 December 2016), Embase Ovid (1947 to 13 December 2016), Latin American and Caribbean Health Sciences Literature Database (LILACS) (1982 to 13 December 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch); searched 13 December 2016, ClinicalTrials.gov (www.clinicaltrials.gov); searched 13 December 2016, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 13 December 2016. We did not use any date or language restrictions in the electronic searches for trials. Selection criteria We included randomized trials that compared at least one type of surgical intervention to another surgical or non-surgical intervention or observation. Data collection and analysis Two review authors independently completed eligibility screening, data abstraction, ’Risk of bias’ assessment, and grading of the evidence. Main results We identified two randomized trials comparing four different surgical treatments for this condition, two methods in each trial. The studies included a total of 45 children and adults. The surgical treatments were all procedures to weaken the ipsilateral inferior oblique muscle. One study compared inferior oblique myectomy to recession of 10 mm; the other study compared inferior oblique disinsertion to anterior transposition (2 mm anterior to the temporal border of the inferior rectus insertion). We judged both studies to be at unclear risk of bias due to incomplete reporting of methods and other methodological deficiencies. Neither study reported data on the primary outcome of this review, which was the proportion of participants with postoperative surgical success, defined as hypertropia less than 3 prism diopters (PD) in primary gaze. However, both studies reported the average reduction in hypertropia in primary gaze. One study found that at 12 months’ postoperatively the average decrease in hypertropia was higher in participants who underwent inferior oblique myectomy than in those who underwent recession, however data were not available for statistical comparison. The other trial found that after at least six months of follow-up, the mean decrease in primary position hypertropia was lower in participants who und...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical interventions for vertical strabismus in superior oblique palsy

Chang¹,

Coleman²,

Tseng³

et al. 2017

Cochrane Database of Systematic Reviews

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“…Los resultados quirúrgicos publicados del tratamiento de las parálisis unilaterales de oblicuo superior son muy buenos y su éxito varía entre un 70-85% (3,7 quirúrgicas es mayor que el de hipercorrecciones, lo cual puede ser debido a que en la mayoría de los trabajos de la literatura sólo operan un músculo, sobre todo el oblícuo inferior hiperfuncionante, realizando técnicas de miectomía, desinserción, recesiones o transposiciones anteriores (6,(10)(11)(12)(13)(14). El porcentaje de hipercorrecciones quirúrgicas publicado en la literatura es variable, desde un 4% hasta un 8,33% (3,5,7,10).…”

Section: Discussionunclassified

“…Para algunos autores las cirugías sobre los rectos verticales serían responsables de la mayor parte de hipercorrecciones obtenidas en sus series, por lo que recomiendan suturar los músculos firmemente a la esclera cuando se retroinserten (15). Otra de las causas publicadas responsables de la hipercorrección de las parálisis del oblícuo superior sería una excesiva cirugía del oblicuo inferior hiperfuncionante, especialmente la transposición anterior (11,18). El cuadro clínico obtenido sería una hipotropía en PPM y una limitación importante de la elevación en aducción.…”

Section: Discussionunclassified

Hipercorrecciones quirúrgica de las parálisis unilaterales del oblículo superior

Merino

Gómez

Gómez-De-Liaño

et al. 2008

Arch Soc Esp Oftalmol

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RESUMENPropósito: Estudiar las causas de la hipercorrección quirúrgica de las parálisis unilaterales del oblicuo superior (POS), y su tratamiento. Material y método: Se identificaron nueve casos con hipercorrección clínicamente significativa intervenidos de POS entre 2004de POS entre -2006. Se analizaron sus causas dividiéndolas en tres patrones: exceso de cirugía, parálisis bilateral enmascarada y sín-drome adherencial o antielevación. Se realizó tratamiento si había diplopía en PPM (posición primaria de la mirada) o en posición de lectura. Se consideró buen resultado la eliminación de la diplopía y una desviación vertical menor de 5 dp ( dioptrías prismáticas) en PPM y menor de 10 dp en posición diagnóstica de los músculos oblicuos. Resultados: El porcentaje de hipercorrecciones quirúrgicas de la POS fue del 27,27%. La hipertropía media preoperatoria fue de 17 dp en PPM, de 18,44 en posición diagnóstica de oblicuos y de 25,22 en la maniobra de Bielschowsky. En siete pacientes se operaron dos músculos. Se empleó anestesia tópica en ocho enfermos. La hipercorrección ocurrió entre los 15 días y los 6 meses de la cirugía. Sus causas fueron: parálisis bilateral enmascarada (dos casos), síndrome antielevación o adherencial (dos casos), y ABSTRACT Purpose: To study causes of overcorrection after surgery for unilateral oblique superior palsy and treatment options. Methods: Nine cases with overcorrection following surgery for unilateral oblique superior palsy between 2004 and 2006 were identified. Their causes were divided into three types: excessive surgery, bilateral masked palsy and antielevation or adherence syndrome. Treatment was required when there was diplopia in primary and reading positions. A good result was achieved if vertical deviation was inferior to 5 prismatic diopters (PD) in primary position (PP) and 10 PD in oblique diagnostic positions. Results: Overcorrection was present in 27.27% of cases. Mean hyperdeviation was 17 PD in PP, 18.4 in oblique positions and 25.22 for the Bielschowsky test. Seven patients underwent two-muscle surgery, and topical anaesthesia was used in eight patients. Overcorrection was diagnosed between 15 days and 6 months following surgery. The etiology was distinct, with 2 patients with bilateral masked palsy, 2 with antielevation or adherence syndrome, and 5 with excessive surgery. Surgical intervention was performed in 6 cases and botulinum toxin used alo-ARCH SOC ESP OFTALMOL 2008; 83: 653-658 ARTÍCULO ORIGINAL

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