Zong Y, Wang Z, Jiang WL, Yang X. Modified inferior oblique anterior transposition for dissociated vertical deviation combined with superior oblique palsy: A case report. World J Clin Cases 2023; 11(12): 2796-2802 [PMID: 37214565 DOI: 10.12998/wjcc.v11.i12.2796]
Corresponding Author of This Article
Xian Yang, MD, PhD, Professor, Department of Ophthalmology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao 266003, Shandong Province, China. yangxian_zhao@qdu.edu.cn
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 26, 2023; 11(12): 2796-2802 Published online Apr 26, 2023. doi: 10.12998/wjcc.v11.i12.2796
Modified inferior oblique anterior transposition for dissociated vertical deviation combined with superior oblique palsy: A case report
Yao Zong, Ze Wang, Wen-Lan Jiang, Xian Yang
Yao Zong, Wen-Lan Jiang, Xian Yang, Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
Ze Wang, Department of Ophthalmology, Nanjing South East Eye Hospital, Nanjing 210007, Jiangsu Province, China
Author contributions: Zong Y and Yang X were the patient’s surgeons; Zong Y contributed to the conception, manuscript writing, revision, and final approval of the manuscript; Jiang WL contributed to the provision of study materials; Yang X and Wang Z contributed to the design, manuscript writing and revision; all authors have read and approved the final manuscript.
Supported byThe Natural Science Foundation of Shandong Province, No. ZR2018BH013; The China Postdoctoral Science Foundation, No. 2017M612214.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xian Yang, MD, PhD, Professor, Department of Ophthalmology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao 266003, Shandong Province, China. yangxian_zhao@qdu.edu.cn
Received: November 15, 2022 Peer-review started: November 15, 2022 First decision: February 14, 2023 Revised: March 3, 2023 Accepted: March 22, 2023 Article in press: March 22, 2023 Published online: April 26, 2023 Processing time: 161 Days and 13.6 Hours
Abstract
BACKGROUND
Inferior oblique anterior transposition (IOAT) has emerged as an effective surgery in the management of dissociated vertical deviation (DVD) combined with superior oblique palsy (SOP). Traditional IOAT usually provides satisfactory primary position alignment and simultaneously restricts the superior floating phenomenon. However, it also increases the risk of the anti-elevation syndrome and narrowing of the palpebral fissure in straight-ahead gaze, especially after the unilateral operation.
CASE SUMMARY
We report the outcomes of the modified unilateral IOAT in two patients with unilateral DVD combined with SOP. The anterior-nasal fibers of the inferior oblique muscle were attached at 9 mm posterior to the corneal limbus along the temporal board of the inferior rectus muscle, the other fibers were attached a further 5 mm temporal to the anterior-nasal fibers. Postoperatively, both hypertropia and floating were improved, and no obvious complications occurred.
CONCLUSION
In these cases, the modified unilateral IOAT was an effective and safe surgical method for treating DVD with SOP.
Core Tip: Inferior oblique anterior transposition (IOAT) is effective for dissociated vertical deviation combined with superior oblique palsy; however, unilateral IOAT also increases the risk of the anti-elevation syndrome. This modified unilateral IOAT involves a more backward new insertion and the new insertion line perpendicular to the inferior rectus muscle axis, which provides satisfactory primary position alignment and restricts the superior floating phenomenon without obvious postoperative complications.
