American Orthoptic Journal Abstract
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Volume 42, 1992, p. 16–25
The Surgical Treatment of Unilateral Superior Oblique Palsy (Abstract)
Carlos Souza-Dias, M.D.
The author reports his experience on the surgical treatment of the unilateral superior oblique palsy. He divides the different clinical pictures into six classes according to the distribution of the hypertropia. among the diagnostic positions, proposes a surgical plan for each class and presents representative cases on which he has operated with the respective results. He points out that the classes have no sharp boundaries; there are intermediate cases, whose surgical plan depends on common sense and the observation of some general exposed principles. As for the Bielschowsky's phenomenon, he says that any well planned surgery for correcting the hypertropia. tends to eliminate it and, consequently, the torticollis. He says the same about cyclotropia, except for those cases in which the fixing eye is the affected one and the other is amblyopic. In that case specific procedures must be done. The 'V' pattern is generally small and does not require special attention, except in some rare cases. The horizontal deviation, that exists in some cases, must be corrected in the usual way. A fact that improves the prognosis is that some small postoperative incomitances tend to disappear with the time, provided there is good fusion, which occurs very often.
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