Postoperative results in inferior oblique palsy

Although rare, the entity of isolated inferior oblique palsy has been discussed in past literature. The purpose of this study is to expand on the number of cases as well as the surgical options. Postoperative clinical findings, especially head-tilt measurements also are discussed.

The charts of patients were retrospectively reviewed following surgical correction of unilateral inferior oblique palsy. Data analyzed included type of surgical correction, pre- and postoperative measurements in all fields of gaze, torsion, and sensory status.

Twenty-eight patients were studied. Patients were separated into groups based on the type of procedure performed. Indications for each type of procedure will be discussed. Twenty-three patients had a single surgical procedure. Of these, 16 had excellent surgical results. Five patients required reoperation with four achieving an excellent surgical result. Head-tilt testing at the last postoperative visit was positive for iatrogenic superior oblique palsy (4) and residual inferior oblique palsy (3).

In the largest series of unilateral inferior oblique palsy to date, the results appear to be good if the indications for the proper surgical procedure are followed. The number of cases of iatrogenic superior oblique palsy appear to be consistent with that discussed in previous literature, but not higher than the incidence of residual inferior oblique palsy. Postoperative head-tilt measurements were consistent with the deviation found in other fields of gaze.