Abstract:

Objective   To evaluate the effectiveness of different surgical approaches for congenital superior oblique paralysis（CSOP） patients and thus investigate the indications of different surgeries. Methods   One hundred and eighty-nine patients（222 eyes）with superior oblique palsy were treated with seven different surgical procedures on the basis of their preoperative examinations. Group A accepted disinsertion of the inferior oblique muscle; Group B accepted inferior oblique myectomy; Group C accepted inferior oblique recession; Group D accepted contralateral inferior rectus muscle recession; Group E accepted other surgical procedures of weakening inferior oblique muscle in combination with rectus muscle; Group F accepted disinsertion of the inferior oblique muscle on one eye and inferior oblique myectomy on the other eye; Group G accepted inferior oblique myectomy on one eye and marginal myotomy of inferior oblique tendon on the other eye. Results   The mean post operative follow-up was 2-24 months. One hundred and sixty-seven(88.36%) cases were cured, and 22 (11.64%) cases were improved. The total effectiveness rate was 100%. Conclusion   Effects of the surgeries for congenital superior oblique paralysis patients are definite. The principle for surgical approaches is to weaken direct antagonist muscle and/or yoke muscle to augment the paralytic muscle. The proper surgical approaches based on the preoperative examinations can obtain higher recovery rates and reduce the risk of second or more operation.

Key words: Congenital superior oblique palsy; Surgery; Curative effect