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• W2046757952 abstract "Purpose To report results of extraocular muscle surgery for superior oblique myokymia when medical treatment fails. Methods A retrospective review of 14 consecutive patients undergoing superior oblique tenectomy and inferior oblique myectomy between 1976 and 2008. Results The mean age of onset of symptoms was 35.4 ± 12.6 years (range, 16-59.5), with a mean duration of oscillopsia of 5 ± 4 years (range, 1.5-17) prior to surgery. Medical treatment was unsuccessful in all 14. Preoperatively, 2 had a small hypertropia that was consistent with an ipsilateral fourth (trochlear) nerve palsy; 12 had no manifest tropia. Postoperatively, all had complete elimination of oscillopsia, and 12 of 14 were free of diplopia in the primary position at 6 meters and 1/3 meter. The only 2 with diplopia in the primary position after surgery were the 2 with a manifest hypertropia preoperatively. Of the remaining 12 patients, 5 had a hypertropia of the affected eye limited to downgaze after surgery (mean of 6.2Δ ± 1.6Δ). Of the 5, 3 needed contralateral inferior rectus surgery, and 1 required prism for downgaze. The mean follow-up was 4.1 ± 2.4 years (range, 0.5-10). At the final visit, none had oscillopsia or uncontrolled diplopia, but 3 (21%) needed prisms. Conclusions Superior oblique tenectomy and inferior oblique myectomy effectively eliminate oscillopsia associated with superior oblique myokymia but result in diplopia in downgaze in approximately 36% of patients, which may cause symptoms in patients who require a bifocal for near work. To report results of extraocular muscle surgery for superior oblique myokymia when medical treatment fails. A retrospective review of 14 consecutive patients undergoing superior oblique tenectomy and inferior oblique myectomy between 1976 and 2008. The mean age of onset of symptoms was 35.4 ± 12.6 years (range, 16-59.5), with a mean duration of oscillopsia of 5 ± 4 years (range, 1.5-17) prior to surgery. Medical treatment was unsuccessful in all 14. Preoperatively, 2 had a small hypertropia that was consistent with an ipsilateral fourth (trochlear) nerve palsy; 12 had no manifest tropia. Postoperatively, all had complete elimination of oscillopsia, and 12 of 14 were free of diplopia in the primary position at 6 meters and 1/3 meter. The only 2 with diplopia in the primary position after surgery were the 2 with a manifest hypertropia preoperatively. Of the remaining 12 patients, 5 had a hypertropia of the affected eye limited to downgaze after surgery (mean of 6.2Δ ± 1.6Δ). Of the 5, 3 needed contralateral inferior rectus surgery, and 1 required prism for downgaze. The mean follow-up was 4.1 ± 2.4 years (range, 0.5-10). At the final visit, none had oscillopsia or uncontrolled diplopia, but 3 (21%) needed prisms. Superior oblique tenectomy and inferior oblique myectomy effectively eliminate oscillopsia associated with superior oblique myokymia but result in diplopia in downgaze in approximately 36% of patients, which may cause symptoms in patients who require a bifocal for near work." @default.
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• W2046757952 date "2009-10-01" @default.
• W2046757952 modified "2023-10-18" @default.
• W2046757952 title "Results of extraocular muscle surgery for superior oblique myokymia" @default.
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• W2046757952 doi "https://doi.org/10.1016/j.jaapos.2009.05.012" @default.
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