Leave That Superior Rectus Alone

Graf and Weihs4 have shown that good results can be obtained with only oblique muscle surgery in cases of superior oblique palsy. They compared the surgical procedures in 51 acquired cases of superior oblique palsy: 28 with IO recess, 5 with superior oblique tuck, and 18 with combined superior oblique tuck and IO recession. They concluded that both Bielschowksy head tilt test and hypertropia on downgaze were more effectively reduced by SO tuck or combined oblique surgery than by IO recession alone.