Effects of Bilateral Superior Oblique "Hang-Back" Recession in Treatment of A-pattern Strabismus with Superior Oblique Overaction

Strabismus. 2016;24(1):1-6. doi: 10.3109/09273972.2015.1130063. Epub 2016 Mar 8.

Abstract

Purpose: To investigate the efficacy and safety of bilateral hang-back recession of superior oblique (SO) muscles in the treatment of A-pattern strabismus with superior oblique overaction (SOOA).

Methods: Thirty-one (31) patients (62 eyes) with A-pattern horizontal deviation and SOOA underwent hang-back recession of SO and retrospective analysis of the surgical amount of hang-back recession of SO, preoperative and postoperative A-pattern, ocular motility, and corrected objective torsion. Patients were evaluated before and 6 to 9 months after surgery.

Results: The average A-pattern horizontal deviation was 27.58 ± 11.47 prism diopters (PD) before surgery and 3.48 ± 3.70 PD after surgery (n=31, P<0.05). The mean corrected A-pattern was horizontal deviation 24.10 ± 10.32 PD. The average scale of SOOA on a scale of +1 to +4 was +3.05 ± 0.80 before surgery and +0.42 ± 0.50 after surgery in 62 eyes (P<0.05). The mean corrected objective torsion was 4.91° ± 4.53°. The surgical amount of SO hang-back recession ranged from 4 to 10 mm (mean: 7.62 ± 1.18 mm), which was related to the preoperative A-pattern and corrected A-pattern. There were no surgical complications.

Conclusions: SO hang-back recession is a safe and efficient option for A-pattern caused by SOOA.

Keywords: A-pattern; superior oblique hang-back recession; superior oblique overaction (SOOA); surgery.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Eye Movements / physiology
  • Female
  • Humans
  • Male
  • Oculomotor Muscles / physiopathology
  • Oculomotor Muscles / surgery*
  • Ophthalmologic Surgical Procedures*
  • Retrospective Studies
  • Strabismus / physiopathology
  • Strabismus / surgery*
  • Vision, Ocular / physiology
  • Visual Acuity / physiology