J Korean Ophthalmol Soc.  2023 Apr;64(4):330-335. 10.3341/jkos.2023.64.4.330.

Surgical Outcomes of Congenital Superior Oblique Muscle Palsy Operated in Adulthood

• Cha YW
• Kim DH

• KMID: 2542167
• DOI: http://doi.org/10.3341/jkos.2023.64.4.330

Abstract

Purpose
To investigate the outcomes of patients who underwent surgical correction of congenital superior oblique muscle paralysis in adulthood.
Methods
We retrospectively analyzed the medical records of 35 patients who underwent surgical correction of congenital superior oblique muscle paralysis after the age of 18 years. At the final follow-up, success was defined as residual hypertropia < 4 prism diopters (PD), whereas failure was defined as residual hypertropia ≥ 5 PD or overcorrection. Clinical features were compared between the success and failure groups to identify factors affecting the surgical outcome. At the final follow-up, the resolution of symptoms, such as head tilt and diplopia, was also recorded.
Results
Of the 35 patients, 24 (68.6%) and 11 (31.4%) were classified into the success and failure groups, respectively. Preoperative vertical deviation was larger in the failure group compared to the success group (23.1 vs. 15.2 PD, respectively; p < 0.05). Of the 31 patients with preoperative head tilt, head tilt resolved in 29 (93.5%). Of the 19 patients with diplopia, it resolved in all except 1 who was overcorrected.
Conclusions
The preoperative vertical angle of the superior oblique muscle may affect the outcome of surgery performed in adulthood for correcting congenital superior oblique paralysis. Head tilt, diplopia, and subjective symptoms are typically resolved postoperatively.

Keyword

Congenital superior oblique palsy, Hypertropia, Vertical strabismus