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

Manabu Miyata, Kiyo Shibata, Ichiro Hamasaki, Masayuki Hata, Yuki Muraoka, Munemitsu Yoshikawa, Satoshi Hasebe, Hiroshi Ohtsuki

Research output: Contribution to journalArticle

3 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
DOIs
Publication statusAccepted/In press - Nov 7 2017

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Paralysis
Depth Perception
Retrospective Studies
Head
Therapeutics

Keywords

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

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Predictive factors for corrective effect of inferior rectus recession for congenital superior oblique palsy. / Miyata, Manabu; Shibata, Kiyo; Hamasaki, Ichiro; Hata, Masayuki; Muraoka, Yuki; Yoshikawa, Munemitsu; Hasebe, Satoshi; Ohtsuki, Hiroshi.

In: Graefe's Archive for Clinical and Experimental Ophthalmology, 07.11.2017, p. 1-7.

Research output: Contribution to journalArticle

Miyata, Manabu ; Shibata, Kiyo ; Hamasaki, Ichiro ; Hata, Masayuki ; Muraoka, Yuki ; Yoshikawa, Munemitsu ; Hasebe, Satoshi ; Ohtsuki, Hiroshi. / Predictive factors for corrective effect of inferior rectus recession for congenital superior oblique palsy. In: Graefe's Archive for Clinical and Experimental Ophthalmology. 2017 ; pp. 1-7.
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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-na{\"i}ve 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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AU - Miyata, Manabu

AU - Shibata, Kiyo

AU - Hamasaki, Ichiro

AU - Hata, Masayuki

AU - Muraoka, Yuki

AU - Yoshikawa, Munemitsu

AU - Hasebe, Satoshi

AU - Ohtsuki, Hiroshi

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N2 - 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.

AB - 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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