J Korean Ophthalmol Soc.  2009 Sep;50(9):1377-1385. 10.3341/jkos.2009.50.9.1377.

Results of Surgical Treatment for Paralytic Strabismus

• Seo YS
• Kyung SE
• Chang MH

• KMID: 2212622
• DOI: http://doi.org/10.3341/jkos.2009.50.9.1377

Abstract

PURPOSE
To study the correction effects of standard recession and resection in paralytic strabismus excluding superior oblique palsy. METHODS: Eighteen cases of paralytic strabismus treated by standard recession and resection from March 2005 to October 2007 were retrospectively analyzed. RESULTS: The average angles of deviation before surgery and after surgery were 55 prism diopters (PD) and 12PD, respectively. Adjustable suturing was performed in 12 cases. The diplopia was improved in 14 out of 18 cases (77%) after surgery. Three cases of the -4 grade paralyzed group had a large residual deviation after surgery. The success rate was 78% (14/18) when success was defined as a residual deviation of less than 15PD. Severe ocular motility limitation (-4 grade) group was less affected than other groups. In the below -3 grade paralyzed groups, patients resolved diplopia in the primary eye position, and did not complain of diplopia by incomitance in the secondary eye position. CONCLUSIONS: Standard recession and resection may actively be attempted in below -3 grade paralytic strabismus patients to resolve diplopia in the primary eye position.

Keyword

Adjustable suture; Diplopia; Incomitant; Paralytic strabismus; Standard recession and resection

MeSH Terms

Diplopia
Eye
Humans
Paralysis
Retrospective Studies
Strabismus

Figure

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  Figure 1. Parinaud syndrome (case 16). The patient shows marked limitation on upgaze.

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  Figure 2. Parinaud syndrome (case 16). 5 months later after both IR recession. The patient shows remained hypotropia in the right and left eye.

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  Figure 3. Right medial rectus palsy (case 8). The patient shows large exodeviation and severe limitation on adduction in the right eye.

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  Figure 4. Right medial rectus palsy (case 8). 2 months after operation. The patient still shows over 60PD exodeviation after recession and resection of the right eye.

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  Figure 5. Right medial rectus palsy (case 8). About one week after operation. The patient shows exodeviaiton after ocular fixation to medial canthal tendon.

Reference

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