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Predictive factors for corrective effect of inferior rectus recession for congenital superior oblique palsy

Graefe's Archive for Clinical and Experimental Ophthalmology volume 256, pages 403–409 (2018)Cite this article

Abstract

Purpose

To identify preoperative factors associated with the surgical corrective effect of contralateral inferior rectus recession (IRR) for vertical deviation in patients with congenital superior oblique palsy (SOP).

Methods

This retrospective study included 20 treatment-naïve patients with unilateral congenital SOP (age range, 6–79 years) who underwent contralateral IRR according to our basic policy to select IRR for paretic eye fixation. The corrective effect (°/mm) of IRR was defined as the difference in the vertical deviation at the primary gaze position between before and 6–18 months after surgery per distance of recession. We also measured the preoperative vertical deviation at primary and secondary gaze positions, and vertical deviation with head-tilting, and calculated the difference in vertical deviation between these positions. We analyzed the correlation between the corrective effect of IRR and these study parameters.

Results

The mean corrective effect of IRR was 2.4 ± 1.6°/mm, which had a significant correlation with preoperative differences in vertical deviation between the primary gaze position and the downward (P = 0.004, r = −0.61) and contralateral gaze positions (P = 0.03, r = −0.48); and the presence of preoperative stereopsis (P = 0.02, r = −0.51). After excluding a statistical outlier, the correlation between the corrective effect and the difference between the primary and contralateral gaze positions was no longer significant (P = 0.07), while the other two relationships remained significant.

Conclusions

Our findings suggest that preoperative differences in vertical deviation between the primary and downward gaze positions and the presence of preoperative stereopsis are important considerations prior to performing IRR for congenital SOP, particularly with paretic eye fixation.

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Funding

The Japanese Ministry of Education, Science, Sports, Culture and Technology provided financial support in the form of a grant (No. 26861451). The sponsor had no role in the design or conduct of this research.

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Affiliations

  1. Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Shogoin Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan

    Manabu Miyata, Masayuki Hata, Yuki Muraoka & Munemitsu Yoshikawa

  2. Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Shikata-cho 2-5-1, Kita-ku, Okayama, 700-8558, Japan

    Kiyo Shibata, Ichiro Hamasaki & Hiroshi Ohtsuki

  3. Department of Ophthalmology 2, Kawasaki-Hospital, Kawasaki Medical School, Nakasange 2-1-80, Kita-ku, Okayama, 700-8505, Japan

    Satoshi Hasebe

Authors
  1. Manabu Miyata
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  2. Kiyo Shibata
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  3. Ichiro Hamasaki
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  4. Masayuki Hata
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  5. Yuki Muraoka
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  6. Munemitsu Yoshikawa
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  7. Satoshi Hasebe
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  8. Hiroshi Ohtsuki
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Corresponding author

Correspondence to Manabu Miyata.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Cite this article

Miyata, M., Shibata, K., Hamasaki, I. et al. Predictive factors for corrective effect of inferior rectus recession for congenital superior oblique palsy. Graefes Arch Clin Exp Ophthalmol 256, 403–409 (2018). https://doi.org/10.1007/s00417-017-3838-z

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  • DOI: https://doi.org/10.1007/s00417-017-3838-z

Keywords

  • Superior oblique palsy
  • Inferior rectus recession
  • Corrective effect
  • Vertical deviation
  • Predictive factor