Outcome of surgery for superior oblique palsy with contracture of ipsilateral superior rectus treated by superior rectus recession

Abstract

Purpose: To report our experience with this special subgroup of patients with superior oblique palsy.

Subjects and methods: All six patients seen since 1990 which the senior author treated who had a unilateral superior oblique palsy accompanied by ipsilateral superior rectus muscle contracture. Surgical management included superior rectus recession along with treatment of the superior oblique palsy by one of several appropriate procedures.

Results: Five out of six had an "excellent" surgical outcome defined as no diplopia in primary and reading position, elimination of their abnormal head posture and normalization of versions postoperatively. The sixth patient continued to have a small intermittent vertical deviation, but was functionally satisfactory.

Conclusions: This subset of individuals with superior oblique palsy and ipsilateral rectus contracture can be improved with weakening of the ipsilateral superior rectus as part of the surgical plan.