Double elevator palsy – Complexities and outcomes
Journal Title: Medpulse International Journal of Ophthalmology - Year 2018, Vol 5, Issue 2
Abstract
Purpose: To evaluate the surgical outcome and stability of surgical correction in patients with double elevator palsy (DEP). Methods: This retrospective study was conducted on hospital records of patients with Double elevator palsy over 3 year period from 2013 to 2016.The cases with positive forced duction test (FDT) had inferior rectus (IR) recession with full tendon width muscle transposition Knapp surgery, while those without positive forced duction test underwent transposition procedure alone. Transposition surgery was combined with recession and resection of horizontal rectus muscles in patients with horizontal strabismus according to the amount of deviation. Eyelid surgery was done in patients with ptosis following strabismus surgery. Results: The average age of 9 patients was 10.55 ± 5.36 years (range, 4– 19years). Six patients (66.66%) were female and 3 patients (33.33%) were male. The mean preoperative hypotropia was decreased from 31.22 ± 12.54 prism diopters (PD) (range, 16–45 PD) to 1.11 ± 2.20PD (range, 0–5 PD) postoperatively. Mean follow-up period was12.33 ± 14.11 months (range, 3–48 months). Four patients (44.4%) underwent ptosis surgery, and all achieved cosmetically satisfactory results Conclusion: Transposition surgery alone or combined with IR recession is an effective procedure in treatment of double elevator palsy but Surgery for double elevator palsy must be individualized.
Authors and Affiliations
Mahesh Thikekar, Chandresh Nandwana, K Veena, Fredrick Mouttapa, Anjali Khadia
Keywords
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