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Tariq S. Alshehri, Michael Flanders, Francois Evoy; Superior Oblique Myokymia: Diagnosis and Management. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1563.
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To describe the clinical features of superior oblique myokymia in 3 patients and to assess the effectiveness of strabismus surgery in 2 of them.
We extracted the history and data from the preoperative and postoperative ophthalmic examinations and recorded the surgical procedures. Head MRI images and photo documentation were obtained for all 3 patients. Ipsilateral superior oblique tenectomy with combined inferior oblique muscle disinsertion and myectomy was performed in 2 of the patients. A surgical outcome was deemed successful if oscillopsia and associated symptoms were eliminated or reduced.
The mean age at diagnosis was 45 years and median follow-up was 8 months. All patients had intermittent vertical oscillopsia not responding to medical treatment. A successful surgical outcome was achieved in the 2 operated patients. One patient had a transient ipsilateral Brown’s syndrome postoperatively.Oscillopsia and associated symptoms disappeared after surgery without long-standing complications.
Symptomatic patients with superior oblique myokymia who have failed to respond to medical treatment, can be successfully managed surgically. Ipsilateral superior oblique tenectomy combined with inferior oblique disinsertion and myectomy is an effective treatment.
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