title: Isolated superior oblique tucking: an effective procedure for superior oblique palsy with profound superior oblique underaction.
abstract: OBJECTIVE
  To compare efficacy and complications of isolated unilateral superior oblique tucking in patients with unilateral superior oblique palsy (SOP).
  
  
  METHODS
  A retrospective analysis of 24 cases of unilateral SOP, 13 Acquired (group 1), and 11 Congenital (group 2), who underwent isolated unilateral superior oblique tuck over a 13-year period was performed.
  
  
  RESULTS
  The mean preoperative vertical deviation in primary gaze was 10 +/- 3 PD for group 1 and 12 +/- 5 PD for group 2 and mean vertical deviation in lateral gaze of affected superior oblique was 19 +/- 5 PD for group 1 and 21 +/- 9 PD for group 2. The mean postoperative vertical deviation in primary gaze for group 1 after a mean follow-up period of 15 +/- 21 months was 1 +/- 3 PD; for group 2 after a mean follow-up period of 17 +/- 13 months was 2 +/- 3 PD, and in lateral gaze of affected superior oblique was 3 +/- 5 PD for group 1 and 5 +/- 6 PD for group 2. The mean correction of vertical deviation in primary gaze at last follow-up was 8 +/- 2 PD for group 1 and 9 +/- 5PD for group 2 ( P > 0.05) and in the lateral gaze field of affected superior oblique muscle was 16 +/- 4 PD for group 1 and 15 +/- 5 PD for group 2 ( P > 0.05). The mean preoperative torsion was 9 +/- 4 degrees for group 1 and 9 +/- 2 degrees for group 2; mean postoperative torsion was 1.2 +/- 2.2 degrees for group 1 and 1 +/- 1 degrees for group 2. The mean torsion corrected for group 1 was 8 +/- 3 degrees and for group 2 was 8 +/- 2 degrees ( P > 0.05). Only one patient in group 1 and three patients in group 2 required reoperation to correct residual deviation. A mild postoperative limitation to elevation in adduction was seen in all cases but was asymptomatic and lessened over time.
  
  
  CONCLUSIONS
  Isolated unilateral superior oblique tucking corrected a large amount of the vertical deviation and torsion with minimal complications in selective patients of both congenital and acquired superior oblique palsy. Superior oblique tucking is a safe and effective procedure and can be considered in patients with SOP meeting selective criteria.
authors.affiliation: Jules Stein Eye Institute, University of California Los Angeles, 90095-7002, USA.
authors.forename: Rahul
authors.initials: R
authors.lastname: Bhola
authors.forename: Federico G
authors.initials: FG
authors.lastname: Velez
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Rosenbaum
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects; D009886:Ophthalmoplegia / Q000151:congenital / Q000503:physiopathology* / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome