Abstract
Introduction: Idiopathic strabismus sursoadductorius is characterized by an overaction of the inferior oblique (IO) muscle, with elevation of the eye in adduction. This can result in chronic headache, eye pain, diplopia and abnormal head posture. Aim: Presentation of clinical results after graded recession of inferior oblique overaction (IOOA) in strabismus sursoadductorius. Method: During a period of 6 years (2012-2017) we performed a dosed transposition of IO muscle in 53 patients in the Department of Ophthalmology of the Semmelweis University and analyzed the clinical results retrospectively. The mean age was 12.8, min-max: 2-51 years. The transposition of the muscle (8 mm, 10 mm or maximal) was performed because of IOOA and was planned depending on the vertical deviation (VD) in maximal adduction. In case of maximal transposition, the insertion of IO was placed under the lateral part of the lower rectus muscle. We evaluated the squint angle in five positions of gaze preoperatively and postoperative 1 week, 1 month and 3-6 months. We examined best corrected visual acuity, binocular vision and complications after surgery. Results: Postoperatively 25 patients had acceptable stereopsis (Titmus 5). Visual acuity remained stable after surgery in all cases. The VD measured in maximal adduction changed with a decrease of 7.5° when 8 mm transposition was performed, and changed with a decrease to 12°, when maximal recession was performed. The mean reduction of VD was 17.8 prism dioptres (PD) after 1 week (p<0.01), 20.5 PD after 1 month and remained stable during a follow-up of 3-6 months. Conclusion: Graded recession of inferior oblique muscle is a suitable proposed procedure in patients with marked strabismus sursoadductorius. The rates of functional under- or overcorrection or other complications are low. Orv Hetil. 2019; 160(27): 1064-1069.
Highlights
Bevezetés: Az idiopathiás strabismus sursoadductorius jellemzője, hogy adductiós helyzetben a szemgolyó túlzottan felfelé áll, az alsó ferde külső szemizom túlműködése miatt
We evaluated the squint angle in five positions of gaze preoperatively and postoperative 1 week, 1 month and 3–6 months
We examined best corrected visual acuity, binocular vision and complications after surgery
Summary
Maneschg Otto Alexander dr. ■ Knézy Krisztina dr. ■ Maka Erika dr. Benyó Fruzsina dr. ■ Sándor Gábor dr. ■ Nagy Zoltán Zsolt dr. Bevezetés: Az idiopathiás strabismus sursoadductorius jellemzője, hogy adductiós helyzetben a szemgolyó túlzottan felfelé áll, az alsó ferde külső szemizom túlműködése miatt. Kulcsszavak: strabismus sursoadductorius, az alsó ferde szemizom túlműködése, dozírozott transzpozíció. Maneschg OA, Knézy K, Maka E, Benyó F, Sándor G, Nagy ZZs. AHP = (abnormal head posture) kényszerfejtartás; BCVA = (best corrected visual acuity) legjobb korrigált látóélesség; BSV = (binocular single vision) binokuláris látás; DVD = (dissociat ed vertical deviation) disszociált vertikális deviáció; HD = (hor izontal deviation) horizontális deviáció; IO = (obliquus inferi or) alsó ferde; IOOA = (inferior oblique overaction) az alsó ferde szemizom túlműködése; IR = (inferior rectus) alsó egye nes; LR = (lateral rectus) laterális egyenes; MR = (medial rec tus) mediális egyenes; PD = (prism dioptre) prizmadioptria; SO = (superior oblique) felső ferde; VD = (vertical deviation) vertikális deviáció.
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