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. 2023 Feb;43(2):511-517.
doi: 10.1007/s10792-022-02449-5. Epub 2022 Aug 17.

Disinsertion-distal myectomy and tucking of inferior oblique combined with superior oblique full tendon advancement in superior oblique palsy

Burçin Kaya  1 , Diğdem Beğendi  2 , Burçin Akdere  3 , Yaşar Duranoğlu  4
Affiliations

Disinsertion-distal myectomy and tucking of inferior oblique combined with superior oblique full tendon advancement in superior oblique palsy

Burçin Kaya et al. Int Ophthalmol. 2023 Feb.

Abstract

Purpose: To assess the preliminary outcomes of inferior oblique (IO) disinsertion-distal myectomy and tucking combined with superior oblique (SO) full tendon advancement in patients with Knapp II or III superior oblique palsy.

Methods: This single-centered retrospective study included 16 eyes from 13 patients with Knapp Class II or III SO palsy. All patients underwent IO disinsertion-distal myectomy and tucking combined with SO full tendon advancement while under general anesthesia. Pre- and post-operative levels of vertical deviation in the primary position, abnormal head position, IO hyperfunction and SO hypofunction, torsion, as well as the presence of diplopia, were all measured, and the differences were statistically compared.

Results: Pre-operatively, 12 patients had abnormal head positions, and two had diplopia. The pre-and post-operative levels of IO hyperfunction and SO hypofunction, as well as a vertical deviation in the primary position and torsion, all differed statistically significantly (p < 0.01).

Conclusions: Inferior oblique disinsertion distal myectomy and tucking combined with SO full tendon advancement surgery appears to be an effective procedure in patients with congenital and acquired Knapp Class II or III SO palsy.

Keywords: Advancement; Hyperfunction; Hypofunction; Inferior oblique muscle; Strengthening; Superior oblique muscle; Torsion.

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