Inferior Oblique Overaction: Anterior Transposition Versus Myectomy

Rajavi, Zhale; Feizi, Mohadeseh; Behradfar, Narges; Yaseri, Mehdi; Sayanjali, Shima; Motevaseli, Tahmine; Sabbaghi, Hamideh; Faghihi, Mohammad Ali

doi:10.3928/01913913-20170309-01

Cited by 12 publications

(10 citation statements)

References 12 publications

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“…study, the preoperative mean IOOA in the myectomy group was higher than the classic recession group. In another study, their results showed that satisfactory improvement in IOOA to a 0 or +1 grade was observed in 26 eyes of the myectomy group (61.9%) and 27 eyes of the classic recession group (67.5%) 12 . Our success in the myectomy group was higher than Rajavi et al.…”

Section: Discussionmentioning

confidence: 45%

Comparing graded anterior transposition with myectomy in primary inferior oblique overaction – A clinical trial

Nabie

Raoufi

Hassanpour

et al. 2019

Journal of Current Ophthalmology

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PurposeTo compare the effects of graded anterior transposition with myectomy in primary inferior oblique overaction (IOOA).MethodsIn a randomized clinical trial study, patients entered into two groups: graded anterior transposition (Group 1) and myectomy (Group 2). In the myectomy method, 8 mm of the inferior oblique (lO) muscle was excised in the lower temporal side, and in the graded anterior transposition group, the IO muscle was recessed according to Wright's method. Patients were followed up for at least 1.5 months. IOOA was graded from 0 to +4. Surgical success was defined as reduced IOOA to a grade of +1 or less.ResultsIn a randomized clinical trial study, a total of 30 patients (60 eyes) were included in the study (32 eyes in Group 1 and 28 eyes in Group 2). Pre-operation IOOA was 3.18 ± 0.78 and 3.25 ± 0.70 in Groups 1 and 2, respectively. Mean IOOA in Group 1 and 2 was 0.95 ± 0.24 and 0.40 ± 0.10 at 6 months after the surgery, which means the mean correction of the overaction was statistically significant in both methods (P < 0.001). The success rate in the myectomy procedure was higher than graded recession. The weakening effect was better in higher grades of overaction (P < 0.001). The overall success rate of Groups 1 and 2 was 75% and 96.4%, respectively (P = 0.029).ConclusionsIn both groups, IOOA significantly decreased after the operation. The success rate of the myectomy procedure was found to be significantly higher than graded anterior transposition.

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Section: Discussionmentioning

confidence: 45%

Comparing graded anterior transposition with myectomy in primary inferior oblique overaction – A clinical trial

Nabie

Raoufi

Hassanpour

et al. 2019

Journal of Current Ophthalmology

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“…In addition, Stein et al 13 reported an average of 2.8 prism dioptre reduction with the myectomy procedure, as opposed to a 4.0 prism dioptre reduction with the use of anterior transposition six weeks post-operatively. Lastly, Rajavi et al 18 reported no significant difference in hypertropia between the two groups.…”

Section: Primary Outcome Residual Inferior Oblique Functionmentioning

confidence: 93%

“…A low level of heterogeneity was present in the studies (I 2 = 0%, P = 0.70). In addition, Stein and Ellis, 13 Kasem and Sabry 16 and Rajavi et al 18 all reported both procedures demonstrated comparable levels of reduction compared to the pre-operative grade. On the other hand, Min et al 14 concluded that the sum of all the apparent inferior oblique muscle dysfunction for the eyes with anterior transposition averaged + 0.1 residual overaction per eye compared with an average of + 1.2 residual overuaction for eyes after myectomy (P = 0.001).…”

Section: Primary Outcome Residual Inferior Oblique Functionmentioning

confidence: 94%

“…Table 1 summarises the baseline characteristics of the included studies. [12][13][14][15][16][17][18][19][20][21][22] The majority of the studies were retrospective with a total sample of 728 subjects. The studies were homogenous in the population and design comparing anterior transposition versus myectomy for the treatment of IOOA.…”

Section: Description Of Studiesmentioning

confidence: 99%

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Inferior Oblique Anterior Transposition versus Myectomy for Inferior Oblique Overaction: Systematic Review and Meta Analysis

Karam

Alsaif

Alhajeri

et al. 2022

European Journal of Ophthalmology

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The objective of this study was to compare the outcomes of inferior oblique anterior transposition (IOAT) versus inferior oblique myectomy (IOM) in patients with primary inferior oblique overaction (IOOA) or secondary IOOA to superior nerve palsy. A systematic review and meta-analysis were performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines and an electronic search was conducted to identify studies comparing IOAT versus IOM for IOOA. Residual inferior oblique function, reduction in hypertropia and post-operative complications were identified as primary outcomes. Secondary outcomes included superior oblique function, head tilt improvement, effect on the contralateral eye, operation time and macular changes. The analysis was based on fixed or random-effects modelling. Eleven studies enrolling 729 patients were identified. Inferior oblique function was not significantly different between both interventions, namely the elimination of IOOA (Odds Ratio[OR] = 0.97, P = 0.97), reduction in IOOA (Mean Difference[MD] = −0.06, P = 0.68), post-operative inferior oblique under-action (OR = 1.06, P = 0.83) and residual overaction (OR = 0.71, P = 0.15). Similarly, no significant difference was noted between both groups in reducing hypertropia. Regarding post-operative complications, no significant difference was observed, including the incidence of anti-elevation syndrome (P = 0.10). No significant difference was noted regarding superior oblique function, improvement in head tilt, effect on the contralateral eye and macular changes, although surgical time was shorter in the IOM group. In conclusion, IOAT and IOM are both effective surgical procedures in the management of IOOA as they produced comparable outcomes in the improvement in hypertropia, post-operative inferior oblique function and incidence of complications.

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“…Various surgical techniques have been reported to weaken the inferior oblique muscle to treat inferior oblique overaction. These include tenotomy (5, 6), 10-mm or 14-mm recession (7), myectomy (3, 8), anteriorization (anterior transposition) (3, 8, 9), extirpation and denervation (3, 10), graded recession-anteriorization (3, 11), anterior and nasal transposition (12), nasal myectomy (13), orbital wall fixation (14), hang-back recession (15), and Z-myotomy (16) of the inferior oblique muscle.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of unilateral versus bilateral inferior oblique recession/anteriorization in unilateral inferior oblique overaction

Mostafa

Kassem

2017

European Journal of Ophthalmology

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The differences between unilateral and bilateral inferior oblique graded recession-anteriorization are insignificant. Unilateral surgery has a higher tendency for the subsequent development of antielevation syndrome. Bilateral surgery may still become complicated by antielevation syndrome, although at a lower rate. In addition, bilateral surgery had a higher rate of undercorrection. Further studies on a larger sample are encouraged.

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Inferior Oblique Overaction: Anterior Transposition Versus Myectomy

Abstract: Both the inferior oblique myectomy and anterior transposition procedures are effective in reducing IOOA with similar satisfactory results. DVD and hypertropia were also corrected similarly by these two surgical procedures. [J Pediatr Ophthalmol Strabismus. 2017;54(4):232-237.].

Cited by 12 publications

References 12 publications

Comparing graded anterior transposition with myectomy in primary inferior oblique overaction – A clinical trial

Comparing graded anterior transposition with myectomy in primary inferior oblique overaction – A clinical trial

Inferior Oblique Anterior Transposition versus Myectomy for Inferior Oblique Overaction: Systematic Review and Meta Analysis

Comparative study of unilateral versus bilateral inferior oblique recession/anteriorization in unilateral inferior oblique overaction

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