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Cyclotorsional diplopia following retinal detachment surgery
1Department of Ophthalmology, University of Rochester School of Medicine and Dentistry, New York 14642.
Journal of Pediatric Ophthalmology and Strabismus
|November 1, 1987
Summary
Torsional diplopia after retinal detachment repair can stem from superior oblique palsy or adhesions. Surgical release of adhesions or advancement of the superior oblique tendon can resolve these debilitating visual disturbances.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Strabismus Surgery
Background:
- Retinal detachment repair is a common ophthalmic procedure.
- Torsional diplopia can be a debilitating complication following such surgeries.
- The superior oblique muscle plays a crucial role in ocular motility and torsion control.
Observation:
- Four patients presented with torsional diplopia post-retinal detachment repair.
- Causes identified included pre-existing superior oblique palsy and iatrogenic adhesions of the superior oblique tendon to surgical implants.
- Two patients had unexplained excyclotorsion despite interventions.
Findings:
- Adhesions of the superior oblique tendon to the encircling band and buckle caused incyclotorsion, which resolved upon surgical release.
- Advancement of the anterior portion of the superior oblique tendon successfully eliminated cyclotorsional symptoms in one patient.
- Conventional interventions like removing scleral exoplants and Harada-Ito surgery showed limited efficacy.
Implications:
- Identifying and releasing superior oblique tendon adhesions is crucial for managing post-surgical torsional diplopia.
- Superior oblique tendon advancement represents a viable surgical option for recalcitrant torsional deviations.
- Further research is needed to elucidate the causes of unexplained torsional deviations after retinal surgery.