Document Detail

Vertical transposition of the horizontal recti (Knapp procedure) for the treatment of double elevator palsy: effectiveness and long-term stability.
MedLine Citation:
PMID:  1486075     Owner:  NLM     Status:  MEDLINE    
Full tendon width vertical transposition (Knapp procedure) of the horizontal recti is an established treatment for double elevator palsy (DEP) but the long-term stability of the surgical results have not been well studied. We undertook a retrospective study to determine the overall effectiveness of the Knapp procedure, the postoperative stability of alignment, and the influence of prior inferior rectus muscle recession (IRc) on the magnitude of correction. Nineteen patients with DEP underwent a Knapp procedure. Eight were corrected to within 5 delta of orthophoria, six were undercorrected, and five were overcorrected by at least 5 delta after a mean follow-up of 3 years (to last visit or to further surgical intervention). The average vertical correction was 37.5 delta in patients who underwent a prior IRc compared with 21.1 delta in patients with no prior IRc (p = < 0.0017). Over and undercorrections were more likely to occur in patients with prior IRc. Postoperative drift was towards increased effect in all patients. The seven patients with long-term (> 36 months) follow-up demonstrated an increased magnitude of correction (average = 12.6 delta) over an average follow-up of 76 months. The Knapp procedure had an increasing effect over time but the amount of vertical correction did not correlate with the size of the preoperative vertical deviation and was less predictable when a prior IRc had been performed.
J P Burke; J B Ruben; W E Scott
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of ophthalmology     Volume:  76     ISSN:  0007-1161     ISO Abbreviation:  Br J Ophthalmol     Publication Date:  1992 Dec 
Date Detail:
Created Date:  1993-02-22     Completed Date:  1993-02-22     Revised Date:  2010-09-07    
Medline Journal Info:
Nlm Unique ID:  0421041     Medline TA:  Br J Ophthalmol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  734-7     Citation Subset:  IM    
Department of Ophthalmology, University of Iowa, Hospitals and Clinics, Iowa City 52242.
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MeSH Terms
Child, Preschool
Oculomotor Muscles / surgery*
Ophthalmology / methods*
Ophthalmoplegia / surgery*
Retrospective Studies
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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