2023 Volume 53 Pages 41-45
【Purpose】To report a case of double elevator palsy, which was accompanied by exotropia (XT) and treated with the Knapp procedure and anterior-posterior transposition of the horizontal muscle.
【Case】The patient in this case was a 19-year-old female. She came to our department for a left droopy eyelid surgery. Her initial eye positions were 30 prism diopters (PD) of XT and 50 PD of left hypotropia. Limited elevation and ptosis of the left eye were observed. A left Knapp procedure, right medial rectus advancement, and right lateral rectus recession were performed. Four months later, the patient underwent left inferior rectus recession and upper eyelid levator shortening. Her postoperative eye position was 10 PD of left hypotropia. At postoperative 7 years, the eye position was 4 PD of esotropia and 14 PD of left hypertropia, an inversion of the preoperative left hypotropia.
【Conclusion】The corrective effect of the Knapp procedure increases over time and may cause a reversal of vertical deviation, suggesting that a long-term follow-up is required to determine the treatment effect.
