Horizontal effect of the surgical weakening of the oblique muscles

PurposeTo determine the postoperative horizontal alignment changes following different inferior oblique (IO) weakening procedures on cases with IO overaction (IOOA).MethodsA total of 40 patients undergoing IO weakening surgery participated in this prospective interventional case series. A comprehensive ophthalmic examination was performed on all patients. The grade of IOOA was assessed based on the muscle function in the gaze of elevation in adduction. All study subjects were operated on by one of the IO weakening procedures including recession, myectomy, or anteriorization, and all were followed up for at least three months after the surgery. Postoperative change of the horizontal alignment in primary position was the main outcome measure.ResultsOur findings showed that all types of IO weakening surgeries improved the postoperative muscle function, hypertopia, and V-pattern significantly (P = 0.001). Generally, IO weakening surgeries had no effect on the postoperative horizontal alignment, and mean exoshift of 0.44 ± 6.2 prism diopters (PD) was observed in all study subjects, specifically. It was found that 70% of cases had no postoperative horizontal changes, 15% showed improvement toward orthophoria, and 15% shifted away from orthophoria.ConclusionsBased on our findings, no horizontal alignment change would be expected in the majority of cases undergoing weakening procedures of overacted IO. Most of our cases did not show any change while a few of them presented eso- or exoshift less than 5 pd which can be clinically ignored.

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“…Souza-Dias et al 29 . studied the horizontal changes of 67 patients undergoing bilateral IO recession or myectomy surgery.…”

Section: Discussionmentioning

confidence: 99%

The effect of inferior oblique muscle weakening on horizontal alignment

Rajavi

Norouzi

Sabbaghi

et al. 2019

Journal of Current Ophthalmology

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“…A secondary function of the SO muscle is abduction. Therefore, a surgery that weakens either the IO or SO muscle could affect abduction and result in esodeviation [234]. The effects of IO weakening surgery on horizontal deviation of the eye have been a topic of debate in the past.…”

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confidence: 99%

Horizontal Effects of 10-mm Inferior Oblique Recession versus 14-mm Inferior Oblique Recession

Kim

2018

Korean J Ophthalmol

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PurposeThe aim of this study was to investigate the quantitative effect of inferior oblique (IO) 10- and 14-mm recession on postoperative horizontal deviation.MethodsPatients (22 men and 18 women) who underwent IO recession were divided into two groups for comparison studies: group 1 (10-mm IO recession, 15 patients) and group 2 (14-mm IO recession, 25 patients). Preoperative and postoperative horizontal deviations were measured, and the resulting horizontal deviations from the 10- and 14-mm IO recession surgeries were compared. The effects of superior oblique underaction, IO overaction, and combined exodeviation on postoperative horizontal deviation were analyzed.ResultsAlthough group 1 did not show a significant horizontal deviation change after surgery (1.9 ± 4.5 prism diopters [PD], p = 0.452), group 2 had a meaningful horizontal change after 14-mm recession (2.2 ± 3.8 PD, p = 0.022). Both groups showed a significant esodrift in horizontal deviation (group 1, p = 0.017; group 2, p = 0.030) in patients with exodeviation over 8 PD. The mean change in horizontal deviation was 6.0 ± 5.4 PD for group 1 and 9.0 ± 5.0 PD for group 2. Although the amount of superior oblique underaction did not affect the extent of change in horizontal deviation, patients with severe IO overaction showed a significant change in horizontal deviation after 14-mm IO recession.ConclusionsFourteen-millimeter IO recession could make a statistically significant change in horizontal deviation after surgery. In addition, esodrift should be considered after IO recession in patients with a preoperative exodeviation greater than 8 PD or severe IO overaction.

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The stability of horizontal ocular alignment of triad exotropia after one-step triple surgery

Xia

et al. 2020

Graefes Arch Clin Exp Ophthalmol

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Horizontal effect of the surgical weakening of the oblique muscles

Cited by 5 publications

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The effect of inferior oblique muscle weakening on horizontal alignment

The effect of inferior oblique muscle weakening on horizontal alignment

Horizontal Effects of 10-mm Inferior Oblique Recession versus 14-mm Inferior Oblique Recession

The stability of horizontal ocular alignment of triad exotropia after one-step triple surgery

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