title: Does inferior oblique recession cause overcorrections in laterally incomitant small hypertropias due to superior oblique palsy?
abstract: OBJECTIVE
  To evaluate the effects of inferior oblique muscle recession (IOR) in cases of laterally incomitant hypertropia <10 prism dioptres (PD) in central gaze thact 2t are clinically consistent with superior oblique palsy (SOP).
  
  
  METHODS
  We retrospectively reviewed patients with SOP and hypertropias <10 PD in central gaze who underwent graded IOR. Primary outcomes were reduction of lateral incomitance and number of overcorrections in central gaze.
  
  
  RESULTS
  Twenty-five patients were included. Mean follow-up was 13.8 months (range 1.4-66). Mean central gaze hypertropia decreased from 5.6±2.1 to 0.2±1.6 PD (p<0.001). Contralateral gaze hypertropia decreased from 15.9±7.6 to 2.3±3.3 PD (p<0.001). Lateral incomitance (central vs contralateral gaze) was 10.3±6.9 PD preoperatively and 2.0±3.0 PD postoperatively (p<0.001). There were two patients overcorrected in central gaze, and one patient overcorrected in downgaze. One patient necessitated further surgery for overcorrection.
  
  
  CONCLUSIONS
  Although small hypertropias can be treated with prisms or small, adjustable inferior rectus recessions, IOR collapses incomitance without causing much overcorrection. IOR is a reasonable treatment for small, laterally incomitant hypertropia due to SOP.
authors.affiliation: Department of Surgery, Division of Pediatric Ophthalmology, Olive View-UCLA Medical Center, 100 Stein Plaza, Los Angeles, CA 90095, USA. velez@jsei.ucla.edu
authors.forename: Karen
authors.initials: K
authors.lastname: Hendler
authors.forename: Stacy L
authors.initials: SL
authors.lastname: Pineles
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Demer
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Rosenbaum
authors.forename: Guillermo
authors.initials: G
authors.lastname: Velez
authors.forename: Federico G
authors.initials: FG
authors.lastname: Velez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004172:Diplopia / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D013285:Strabismus / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D013536:Suture Techniques; D020432:Trochlear Nerve Diseases / Q000150:complications*; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult