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Surgical treatment in patients with double elevator palsy
Nazife Sefi Yurdakul1, Seyda Ugurlu, Ahmet Maden
1Department of Ophthalmology, Izmir Ataturk Education and Research Hospital, Izmir - Turkey. nsefi@yahoo.com
European Journal of Ophthalmology
|September 30, 2009
Summary
Surgical transposition, with or without inferior rectus recession, effectively treats double elevator palsy (DEP). This surgery also corrects horizontal deviations in patients with exotropia.
Area of Science:
- Ophthalmology
- Strabismus Surgery
- Pediatric Ophthalmology
Background:
- Double elevator palsy (DEP) is a rare congenital condition affecting vertical eye movements.
- Surgical management of DEP aims to improve ocular alignment and function.
Purpose of the Study:
- To evaluate the effectiveness of surgical interventions for congenital double elevator palsy (DEP).
Main Methods:
- Retrospective analysis of 13 patients with congenital DEP (2003-2007).
- Surgical techniques included inferior rectus recession, muscle transposition (Knapp surgery), and horizontal rectus muscle recession/resection for exotropia.
- Eyelid surgery was performed for associated ptosis.
Main Results:
- Significant reduction in preoperative hypotropia (mean 29.2 PD to 2.6 PD).
- Successful correction of horizontal deviation in exotropic patients (median 30 PD to 2 PD).
- Eyelid surgery yielded satisfactory cosmetic results in 5 patients.
Conclusions:
- Transposition surgery, alone or with inferior rectus recession, is effective for DEP.
- Combined procedures correct vertical deviations and horizontal deviations simultaneously when needed.