The Clinical Course of Superior Oblique Tuck Surgery in Patients with Unilateral Superior Oblique Palsy

PURPOSE: To evaluate the effects of surgery depending on the follow-up duration after superior oblique tuck was performed as the first surgery in unilateral superior oblique palsy patients. METHODS: Sixteen patients who were followed-up for a minimum of 3 months were retrospectively evaluated. The vertical deviation, abnormal head posture, superior oblique underaction, and inferior oblique overaction were evaluated before and at 3, 6, and 12 months after the surgery and at the last follow-up. The angle between the center of the optic disc and fovea (disc-fovea angle) was measured using fundus photography to investigate changes in ocular torsion. RESULTS: The mean follow-up period was 24.9 ± 21.9 months and the mean tuck was 11.4 ± 4.0 mm. Vertical deviation <7 prism diopters in the primary position was observed in 53.9% of patients at 3 months postoperatively, 50.0% at 6 months, 83.3% at 12 months, and 62.5% at the last follow-up (p = 0.55). Head posture was improved in 66.7% of patients at 3 months, 71.4% at 6 months, 50% at 12 months, and 80% at the last follow-up after surgery (p = 0.73). Ocular torsion was decreased in 37.5% of patients at 3 months postoperatively, 66.7% at 6 months, 75% at 12 months, and 80.0% at the last follow-up (p = 0.11). Superior oblique underaction was improved in 100%, 77.8%, 60%, and 75% of the patients and inferior oblique overaction was improved in 100%, 88.9%, 85.7%, and 81.3% of the patients at postoperative month 3, 6, and 12, and at the last follow-up, respectively. CONCLUSIONS: Superior oblique tuck resulted in the maintenance of an improved condition of patients at 3, 6, and 12 months postoperatively, and there was no significant difference in motor measurements between the follow-up periods.

Effect of Superior Oblique Tuck Surgery in the Patients with Unilateral Superior Oblique Palsy

This study was conducted to assess the amount of superior oblique tuck surgery and the corrected amount of vertical strabismus and head tilt after superior oblique tuck surgery in patients with unilateral superior oblique palsy.Superior oblique tuck surgery was performed on 13 patients with unilateral superior oblique palsy, which corresponded to the second or the third type with hypertropia of 25 PD (prism diopters)or less of Knapp classification. The mean preoperative vertical deviation was 17.8 PD and the mean postoperative vertical deviation was 8.8 PD:the mean corrected amount of vertical deviation was 9.0 PD.Head tilt, which had been observed in 10 (77%)patients preoperatively, improved by over 5 degrees, head tilt in 5 (50%)of them postoperatively.The results suggest that superior oblique tuck surgery may as well be combined with ipsilat eral inferior oblique weakening or with ipsilateral or contralateral vertical rectus muscle surgery in unilateral superior oblique palsy patients with the amount of vertical deviation of 15 PD or more.