Inferior oblique syndrome: An under-recognised complication of strabismus surgery

Abstract

Purpose To show the predictive factors that would indicate the possibility of inferior oblique inclusion when considering surgery on a previously operated lateral rectus muscle. We also aim to highlight the importance of freeing any inferior oblique attachment to the lateral rectus muscle during either a resection or a recession procedure. Methods A retrospective review was

Adjustment of the surgical nomogram for surgery on slipped extraocular muscles

“…In these cases strabismus surgery to free the IO fibers often fails to reduce the vertical deviation. 5 One patient was noticed to have 2 lateral rectus tendon heads separated from each other; one at the original site of insertion and one at the recessed position. In this case the anterior tendon head was isolated on a separate tendon hook after clearing the connective tissue, which was then recessed along with the posterior tendon insertion.…”

“…8 This period allows time for recovery of the muscle function and improvement in ductions but prevents significant contracture. 5 Surgery on a slipped muscle involves forced duction testing, clearing the surrounding connective tissue from the muscles, and measuring the exact location of all the muscles concerned. A definitive diagnosis is made intraoperatively.…”

Vertical Deviations Improved With Release of Postoperative Inferior Oblique Muscle Inclusion

“…3,4 In the current study, 45 patients were found to have a significantly reduced vertical deviation resulting from released IO muscle inclusion. This correction has been stable for a follow-up period of 2 to 10 years without recurrence of the previous amount of vertical deviation.…”

A conventional strabismus surgical approach for lost medial rectus muscles

“…Reoperation on a patient within 10 days of the original surgery prevents contracture of the lost muscle. 3,7 In our case series, cases 1 and 2 underwent reoperation 1 day after the previous surgery. Case 3 underwent reoperation 1 week after the initial surgery.…”