Surgical effects of nasal transposition of inferior rectus muscle – 135 cases of acquired superior oblique palsy

Figures & data

Table 1 Diagnostic criteria for acquired and decompensated superior oblique palsy

SO palsy	Criteria
Acquired	• Sudden onset
	• Complication of vertical deviation and excyclodeviation
	• Exacerbation of diplopia (or vertical deviation) in down gaze
	• Positive BHTT
	• Exclusion of myasthenia gravis and thyroid ophthalmopathy
Decompensated	• Indeterminate onset of diplopia
	• Complication of vertical deviation and excyclodeviation
	• Positive BHTT
	• Exclusion of myasthenia gravis and thyroid ophthalmopathy

Abbreviations: SO, superior oblique; BHTT, Bielschowsky head-tilt test.

Figure 1 Surgical procedure of inferior rectus (IR) nasal transposition. IR was recessed and transposed nasally along with the spiral of Tillaux in the case of vertical deviation and excyclodeviation.

Abbreviations: LR, lateral rectus; MR, medial rectus; SR, superior rectus.

Table 2 Surgical effects of inferior rectus nasal transposition

Muscle width	Cases (n)	Excyclodeviation (mean ± standard error)
		Preoperative	Postoperative	Surgical effect
1/2	14	4.1±0.6	0.9±0.3	3.3±0.5
2/3	19	4.9±0.4	1.6±0.4	3.3±0.6
1	90	8.0±0.3	2.4±0.2	5.6±0.3

Table 3 Relationship between amount of inferior rectus recession and corrective effect in excyclodeviation

Recession (mm)	Cases (n)	Excyclodeviation (mean ± standard error)
		Preoperative	Postoperative	Surgical effect
0	11	9.8±0.9	3.9±0.9	5.9±0.9
1	19	7.8±0.6	2.9±0.5	4.9±0.7
2	27	7.4±0.6	2.0±0.3	5.4±0.5
3	21	7.6±0.5	1.8±0.4	5.8±0.6
4	9	8.6±0.8	2.4±0.8	6.2±0.8
5	3	9.5±0.8	2.7±0.9	6.8±0.4