Abstract

MERINO, P. et al. Overcorrection after surgery for unilateral superior oblique palsy. Arch Soc Esp Oftalmol [online]. 2008, vol.83, n.11, pp.653-658. ISSN 0365-6691.

Purpose: To study causes of overcorrection after surgery for unilateral oblique superior palsy and treatment options. Methods: Nine cases with overcorrection following surgery for unilateral oblique superior palsy between 2004 and 2006 were identified. Their causes were divided into three types: excessive surgery, bilateral masked palsy and antielevation or adherence syndrome. Treatment was required when there was diplopia in primary and reading positions. A good result was achieved if vertical deviation was inferior to 5 prismatic diopters (PD) in primary position (PP) and 10 PD in oblique diagnostic positions. Results: Overcorrection was present in 27.27% of cases. Mean hyperdeviation was 17 PD in PP, 18.4 in oblique positions and 25.22 for the Bielschowsky test. Seven patients underwent two-muscle surgery, and topical anaesthesia was used in eight patients. Overcorrection was diagnosed between 15 days and 6 months following surgery. The etiology was distinct, with 2 patients with bilateral masked palsy, 2 with antielevation or adherence syndrome, and 5 with excessive surgery. Surgical intervention was performed in 6 cases and botulinum toxin used alone or associated with surgery in 4 cases. A good result was obtained in 8 patients. Conclusion: The incidence of overcorrection was high, with most of these requiring surgical intervention for which good results were obtained.

Keywords : Surgical overcorrection; superior oblique palsy; antielevation-adherence syndrome; bilateral masked palsy.

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