2 Cases of Traumatic Inferior Oblique Palsy

PURPOSE: Inferior oblique palsy is the least commonly isolated extraocular muscle palsy. We describe the clinical features and managements of 2 cases of traumatic inferior oblique palsy. METHODS: Two adult patients were presented with vertical diplopia and head tilt posture after head trauma. The subjects fulfilled the three-step test criteria, with a hypertropia that worsened on side gaze and head tilt away from the affected eye. They showed free forced duction to elevation in adduction. Both were treated by ipsilateral superior oblique tenotomy and contralateral superior rectus recession with adjustable suture technique. RESULTS: During postoperative 7 month observation, both patients demonstrated orthophoria in primary gaze. Our surgical procedures eliminated the diplopia and abnormal head tilt posture, thereby achieving satisfactory results.

Astigmatic Correction of LASIK

PURPOSE: The authors studied the results of excimer laser in situ keratomileusis for correction of myopic astigmatism. METHODS: The authors studied the results of 108 eyes(83 patients) who underwent excimer laser in situ keratomileusis for correction of myopic astigmatism and had preoperative atigmatism greater than 0.5 diopter(D). Each patient had been followed up for over 12 months since January 1996. Refractive errors, uncorrected visual acuity(UVA) and best corrected visual acuity(BCVA) were measured at postoperative 1, 3, 6 months and 1 year, respectively. And astigmatic changes were analyzed by vector analysis using the Holladay formula. RESULTS: Twenty-five patients were male; 58 were female. Mean spherical equivalent was -11.64 D +/-4.03 D preoperatively and -1.32 D+/-1.73 D at postoperative 1 year. In group I(31 eyes:0.50 D~0.75 D),II(46 eyes:1.00 D~1.75 D), III(15 eyes:2.00 D~2.75 D), IV(16 eyes:3.00 D~6.50 D), postoperative astigmatism were 0.60+/-0.73 D, 0.58+/-0.72 D, 0.75+/-0.89 D, 0.62+/-0.60 D at ostoperative 1 year. In 17.2% of all the eyes, axis deviation within 30 degrees was noted 1 year after the surgery. By vector analysis, astigmatic errors were corrected within 0.50 D of the attempted amount in 64.5% of group I, 63.0% of group II, 56.0% of group III and 66.7% of group IV. UVA was 0.5 or better in 69%, and 0.8 or better in 46% at postoperative 1 year. CONCLUSIONS: BCVA did not change after the surgery in most of the eyes. The greater the amount of preoperative astigmatism, the more effective the postoperative astigmatic correction