Purpose. To further define the clinical features of patients with inferior oblique muscle overaction (IOOA) and evaluate the surgical results in a subgroup of these patients. Methods. The medical records of 173 patients who underwent inferior oblique muscle (IO) weakening surgery due to primary or secondary IOOA were retrospectively reviewed. The patients were assigned a surgical group based on severity of IOOA and presence of dissociated vertical deviation (DVD) or hypertropia. Patients with +1 or +2 IOOA underwent recession, patients with +3 or +4 IOOA underwent myectomy, and patients with any grade of IOOA and DVD or hypertropia underwent anterior transposition (AT) surgery. Results. A total of 286 eyes of 173 patients who underwent surgery due to IOOA were included in the study. IOOA was accompanied by esotropia, exotropia, abnormal head posture (AHP), pattern strabismus, convergence insufficiency, DVD, facial asymmetry, and nystagmus. The most common comorbid disorder was esotropia. The recession was used in 173 eyes, myectomy in 64, and AT in 49. Surgical success was obtained in 96.0% of eyes that underwent recession, in 98.4% of eyes that underwent myectomy, and in 93.9% of eyes that underwent AT. In the follow-up, IOOA occurred in the fellow eye in 36.1% of patients who underwent unilateral surgery. Conclusions. This study is a comprehensive report on the concomitants of the IOOA. Also, it showed that all of the three surgical procedures including recession, myectomy, and AT are effective in the surgical management of IOOA when performed in select patient groups.
To evaluate the results of phacoemulsification (PE) surgery in completely monocular cases and to emphasize the important points in the pre-, intra-and post-operative periods. Material and Methods: A total of 42 patients who had no light perception in one eye and had underwent PE surgery in the other eye at our clinic between January 2014 and March 2016 were included in the study. The charts of the patients were evaluated retrospectively. The age and gender of the cases, whether there was an additional pathology in the eye undergoing surgery, the reason of visual loss in the other eye, the type of anesthesia used, pre-and post-operative best corrected visual acuity (BCVA) with the Snellen chart, intraocular pressure and intra-and post-operative complications were investigated. Results: There were17 (40.5%) female and 25 (59.5%) male patients with a mean age of 74.2±10.5 (45-93) years. The most common causes of the monocular state were glaucoma, cataract and trauma, the most common accompanying pathologies in the eyes undergoing cataract surgery were glaucoma, zonular weakness and age-related macular degeneration. Mean BCVA was 0.07±0.1 (0.01-0.4) pre-operatively and 0.5±0.3 (0.01-1) post-operatively (p≤0.001). The mean follow-up duration was 3.9±5.6 months (1 week to 24 months). The most common post-operative complication was corneal edema. Conclusion: The stress created by cataract surgery on the physician and patient is quite high in monocular cases. However, satisfactory results with PE are obtained in these cases by carefully using pre-, intra-and post-operative methods.
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