Clinical features and surgical treatment of double elevator palsy in young children

Luo, Wenting; Qiao, Tong; Ye, Haiyun; Li, Sihong; Chen, Quanli

doi:10.18240/ijo.2018.08.16

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…1 a & b). We reported the management of double elevator palsy patients with standard Knapp procedures or augmented Knapp procedures in 2018 [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Ophthalmological outcomes of unilateral coronal synostosis in young children

et al. 2020

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Background: To report refractive outcomes, describe types of strabismus and evaluate the outcomes of surgical intervention for unilateral coronal synostosis (UCS) in paediatric patients. Methods: This study retrospectively included 30 UCS cases. Patients aged from 3 months to 6 years (median: 1.8 years) were enrolled from January 2018 to December 2019 at Shanghai Children's Hospital. Sixteen patients had all types of strabismus; 15 of these patients underwent surgery. Results: Refractive errors of 30 cases were included. In 60% of patients, astigmatism of 1.00D or more existed in not less than one eye at last record. Twenty (66.7%) patients had the larger amount of astigmatism in the contralateral eye. Fifteen patients received strabismus surgery, of whom 6 patients with monocular elevation deficiency (MED) underwent the standard Knapp procedure, with or without a horizontal deviation procedure. Fifteen cases were horizontally aligned within 5 prism dioptres (Δ). Six patients with MED (100%) had attained ≥25% elevation improvement after surgery, and the vertical deviation decreased from 25.83 Δ ± 4.92 Δ (range, 20 Δ-30 Δ) to 0.83 Δ ± 4.92 Δ after surgery (range, 0 Δ-10 Δ), for an improvement of 26.67 Δ ± 4.08 Δ (t = 16 P < 0.05). In 1 patient with esotropia, the horizontal deviation decreased from + 80 Δ to + 5 Δ after surgery. One patient was diagnosed with trichiasis and one with contralateral lacrimal duct obstruction. Conclusions: Contralateral MED was also the main type of strabismus in UCS. Superior oblique muscle palsy was still the most common, as previously reported. There is a risk of developing a higher astigmatism and anisometropia in the contralateral eye to synostosis. Other ophthalmic disorders should be treated in a timely manner. Trial registration: The study was approved by the Institutional Review Board of Shanghai Children's Hospital (approval No. 2020R023-E01) and adhered to the tenets of the Declaration of Helsinki. Ethics approval was procured on March 30, 2020. This was a retrospective study. Written informed consent was sought from the patients' parents or legal guardians. Clinical Trials Registry number: ChiCTR2000034910. Registration URL: http://www.chictr.org.cn/showproj.aspx?proj=56726.

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“…1 a & b). We reported the management of double elevator palsy patients with standard Knapp procedures or augmented Knapp procedures in 2018 [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Ophthalmological outcomes of unilateral coronal synostosis in young children

et al. 2020

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Comparison of different tendon transposition techniques for the treatment of monocular elevation deficiency type 2

Ocak

İnal

Aygıt

et al. 2020

Journal of American Association for Pediatric Ophthalmology and

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Outcomes of a Simple Lateral Rectus Belly Transposition Procedure Combined With Ipsilateral Antagonist Recession for Vertical Rectus Palsy

Xia¹,

Ling²,

Wen³

et al. 2022

J Pediatr Ophthalmol Strabismus

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Purpose: To report the surgical effects of a combination treatment comprising the lateral rectus belly transposition (LRBT) procedure, without muscle splitting or disinsertion, and ipsilateral antagonist recession for vertical rectus palsy. Methods: The medical records of consecutive patients who underwent the LRBT procedure between 2017 and 2020 were reviewed. Preoperative and postoperative deviation in primary position, preoperative and postoperative scale of duction of the palsied muscle, any induced horizontal or torsional deviation, and other complications were collected. Results: Thirteen patients were identified: 10 with inferior rectus palsy and 3 with superior rectus palsy. The mean postoperative follow-up time was 20.4 ± 8.0 months. Eleven patients (84.6%) underwent simultaneous recession of the ipsilateral antagonist muscle of the palsied vertical rectus. After surgery, the mean vertical deviation improved from 31.4 ± 16.4 to 1.9 ± 3.6 prism diopters (PD) ( P < .001). The mean vertical duction limitation of the palsied muscle improved from −2.7 ± 0.6 to −0.6 ± 0.5 ( P = .001). In one patient, the scleral fixation suture was removed due to continuous reverse vertical diplopia. The total success rate was 76.9%. No induced horizontal deviation was noted. Anterior segment ischemia or other severe surgical complications did not occur. Conclusions: The LRBT procedure can be effective, safe, and reversible in patients with vertical rectus palsy. It allows for the option of simultaneous ipsilateral antagonist recession, and it is especially valuable in patients whose vertical duction deficiency is worse in abduction but mild in adduction. [ J Pediatr Ophthalmol Strabismus . 2022;59(6):396–404.]

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Clinical features and surgical treatment of double elevator palsy in young children

Cited by 3 publications

References 13 publications

Ophthalmological outcomes of unilateral coronal synostosis in young children

Ophthalmological outcomes of unilateral coronal synostosis in young children

Comparison of different tendon transposition techniques for the treatment of monocular elevation deficiency type 2

Outcomes of a Simple Lateral Rectus Belly Transposition Procedure Combined With Ipsilateral Antagonist Recession for Vertical Rectus Palsy

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