Horizontal effect of the surgical weakening of the oblique muscles

Souza-Dias, Carlos

doi:10.1590/s0004-27492011000300007

Cited by 10 publications

(4 citation statements)

References 17 publications

(4 reference statements)

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“…Souza-Dias [12] investigated the effect of superior oblique muscle weakening on horizontal alignment in primary position and found esoshift in three patients and exo-shift in four patients whereas the horizontal alignment in primary position was not affected in five patients and calculated that this procedure caused 2.25Δ exo-shift. In the present study, we found a median amount of 4Δ esoshift in horizontal near and distance measurements in primary position regardless of the type of surgery for inferior oblique muscle.…”

Section: Discussionmentioning

confidence: 99%

Inferior Oblique Muscle Weakening: Is It Possible to Quantify Its Effects on Horizontal Deviations?

Şekeroğlu

Dikmetaş

Sanaç

et al. 2012

Journal of Ophthalmology

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Objective. To evaluate and quantify the effect of inferior oblique muscle weakening on horizontal deviations. Methods. The medical files of patients who had undergone an inferior oblique weakening as a single procedure were all reviewed. The main measures were the type of inferior oblique overaction (IOOA), pre- and postoperative amount of IOOA, and horizontal deviations in primary position. Results. The study was conducted with 66 patients (30 males, 36 females). The median age was 11 years (1–49). Of the 66 patients, 30 (45.5%) had primary and 36 (54.5%) had secondary IOOA. The most common procedure was inferior oblique anteriorization in 32 patients (48.5%). The mean postoperative horizontal and vertical deviations and the amount of IOOA were decreased postoperatively (p = 0.001 for all). The median amount of correction of horizontal near and distance deviations was 4Δ (0–20). The preoperative amount of IOOA, the presence of fourth nerve palsy, and the type of the weakening procedure had no significant effect on the amount of correction of horizontal deviations. Conclusion. The inferior oblique weakening procedures have secondary effects and warrant reduction of horizontal deviations in varying degrees. This should be borne in mind in planning a simultaneous horizontal muscle surgery and setting the surgical amount.

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Section: Discussionmentioning

confidence: 99%

Inferior Oblique Muscle Weakening: Is It Possible to Quantify Its Effects on Horizontal Deviations?

Şekeroğlu

Dikmetaş

Sanaç

et al. 2012

Journal of Ophthalmology

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“…Sousa-Dias reported on 12 patients who underwent isolated superior oblique weakening and found an average exotropia shift of 2.25∆, which they deemed a "clinically negligible amount," and concluded that a change in horizontal alignment need not be taken into account when weakening the superior oblique. 5 In our study, more patients were adjusted for overcorrection postoperatively in the LRc with IOM group compared with the LRc alone group. This may imply that weakening of the inferior oblique contributed to an esotropic shift in the immediate postoperative period, leading to more overcorrection and thus the need for adjustment after surgery.…”

Section: Discussionmentioning

confidence: 68%

“…1,2 Similarly, some studies have focused on the effect of weakening the superior oblique, whose tertiary action is also abduction. [3][4][5] These studies also suggest that a negligible shift in primary position is observed with superior oblique weakening.…”

Section: Introductionmentioning

confidence: 97%

Effect of inferior oblique myectomy on primary position when combined with lateral rectus recession for intermittent exotropia

Scelfo

Elhusseiny

Alkharashi

2021

European Journal of Ophthalmology

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Purpose: To evaluate the surgical success and need for adjustment due to overcorrection in patients who undergo inferior oblique myectomy (IOM) combined with lateral rectus recession (LRc) for intermittent exotropia in the setting of inferior oblique overaction. Methods: A retrospective chart review was conducted of patients with intermittent exotropia who underwent LRc using adjustable sutures alone versus LRc combined with IOM between January 2010 and July 2018 at our institution. Binocular alignment was recorded before and within one week of surgery. Evaluation measures noted were surgical success (defined as distance alignment of ⩽10 prism diopters) and need for postoperative adjustment due to overcorrection. Results: Of 48 patients, 24 underwent LRc alone and 24 underwent LRc combined with IOM; all 48 patients had adjustable sutures. Surgical success was significantly higher in the LRc alone group (91.6%) compared with the LRc with IOM group (62.5%) ( p = 0.036). The need for postoperative adjustment due to overcorrection was also significantly higher in the LRc with IOM group (20.8%) compared with the LRc alone group (0%) ( p = 0.049). Conclusions: In this study, more patients needed adjustment for overcorrection after undergoing LRc combined with IOM versus LRc alone. Since the tertiary action of the inferior oblique is abduction it is possible that, in patients with inferior oblique overaction, surgically weakening the inferior oblique causes more esodeviation and overcorrection. Thus, surgical correction of exotropia and inferior oblique overaction using LRc combined with IOM may lead to overcorrection and increased need for postoperative adjustment.

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“…The effect of superior oblique weakening on the horizontal deviation in primary gaze has been variously described as no shift at all (Dias and colleagues), 5 an esoshift (Shuey and colleagues), 6 or a very small exoshift (Diamond and Parks 7 and Fierson and colleagues 8 ). The present study adds to the body of data on the effect of oblique muscle weakening procedures on the horizontal alignment.…”

Section: Effect Of Combining Oblique Muscle Weakening Procedures Withmentioning

confidence: 99%

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Demir

Yücel

Niyaz

et al. 2015

Journal of American Association for Pediatric Ophthalmology and

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Horizontal effect of the surgical weakening of the oblique muscles

Cited by 10 publications

References 17 publications

Inferior Oblique Muscle Weakening: Is It Possible to Quantify Its Effects on Horizontal Deviations?

Inferior Oblique Muscle Weakening: Is It Possible to Quantify Its Effects on Horizontal Deviations?

Effect of inferior oblique myectomy on primary position when combined with lateral rectus recession for intermittent exotropia

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