The Surgical Outcome of Inferior Oblique Recession on Bilateral Superior Oblique Palsy in Children†
Patcharapim Masaya-anon MD*, Irene Subhangkasen MD*, Juthathip Hiriotappa MD*
Affiliation : † This article was presented in the 20th scientific meeting of the Royal College of Ophthalmologists of Thailand on 22nd November to 23rd November 2007 in Bangkok, Thailand * Department of Ophthalmology, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
Objective : To study the surgical effects of bilateral graded inferior oblique muscle (IO) recession on the
reduction of the V pattern deviation and severity of inferior oblique muscle overaction (IOOA) in children who
had bilateral superior oblique muscle palsies(SOP) with secondary inferior oblique muscle overaction.
Material and Method: Seven patients who presented with bilateral SOP with secondary IOOA were included.
All patients had V pattern deviation and bilateral graded IO recession was done. The data of age, sex,
deviation in primary position, V pattern and severity of IOOA was recorded both pre- and post -operatively.
The comparison of pre-operative and post-operative amount of V pattern and IOOA was analyzed with non-
parametric statistical analysis.
Results : Four females and three males had the average age of 5.7 + 1.8 years old. The mean pre-operative
severity of IOOA was + 3 and the mean pre-operative deviation of the V pattern was 36 + 11.4 prism diopters
(PD). The mean post-operative severity of IOOA was + 0.4 and of V pattern deviation was 10.7 + 4.4 PD.
Comparing the pre-operative and post-operative severity of IOOA and V pattern deviation by non-parametric
statistical analysis and the result was statistically significant.
Conclusion : Bilateral graded IO recession is an effective surgical procedure to reduce the V pattern and the
severity of IOOA in the children who are suffering from bilateral SOP with secondary IOOA.
Keywords : Eye movements, Oculomotor muscles, Bilateral superior oblique palsy, V pattern, Inferior oblique recession
