Isolated inferior oblique myectomy for vertical deviations of at least 20 prism diopters in the primary position

Raoof, Naz; Burke, John P.

doi:10.1016/j.jaapos.2015.11.009

Cited by 8 publications

(2 citation statements)

References 6 publications

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“…[ 12 ] Reported success rates are in the range of 72%–96%, and satisfactory and predictable results can be obtained in cases with small to moderate hypertropia <15 PD while the success rate is reduced in cases with a larger angle of deviation. [ 10 13 14 ] Similarly, Raoof and Burke[ 15 ] reported a mean vertical deviation reduction of 11.4 PD in their study on patients with ≥20 PD of IOO in the primary position.…”

Section: Discussionmentioning

confidence: 95%

Inferior oblique overaction: The results of myectomy in cases with a primary position vertical deviation less and more than 20 prism diopters

Sefi-Yurdakul

Gucyetmez

2020

Middle East Afr J Ophthalmol

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PURPOSE: The purpose of this study is to evaluate the results of myectomy in inferior oblique overaction cases with a vertical deviation angle of <20 and ≥20 prism diopters (PD) in the primary position. METHODS: The medical records of cases with inferior oblique overaction that underwent inferior oblique myectomy for ≥6 PD hypertropia in the primary position and >+1 inferior oblique overaction were reviewed. Preoperative and postoperative examination findings and success rates were compared of cases with a deviation angle <20 PD (Group 1) and ≥20 PD (Group 2). RESULTS: The mean age of 35 (58%) female and 25 (42%) men cases of Group 1 ( n = 60) were 12.8 ± 9.4 years; the mean age of 25 (58%) female and 18 (42%) male cases of Group 2 ( n = 43) were 14.8 years ( P = 0.340). The near hypertropia was decreased from 11 to 0.5 PD in Group 1, from 22.1 to 5.1 PD in Group 2 cases ( P < 0.001). The distance hypertropia was decreased from 11.3 to 0.5 PD in Group 1 and from 23.3 to 6.1 PD in Group 2 cases ( P < 0.001). The mean degree of hypertropia at near and distance was statistically significantly higher both pre- and post-operatively in Group 2 than in Group 1 ( P < 0.001), and improved statistically significantly with the initial surgery in both groups ( P < 0.001). The rate of the presence of stereopsis of ≥3000 s/arc and fusion, the main criteria of binocular vision (BOV), was not statistically significantly different between the Groups before ( P = 0.577) and after the surgery ( P = 0.678), but the presence of BOV significantly increased both in Group 1 ( P < 0.001) and Group 2 ( P = 0.004) postoperatively. The number of cases with surgical success was 57 (95%) and 25 (58%), respectively, in Groups 1 and 2 ( P < 0.001). CONCLUSIONS: Myectomy is an effective surgical procedure that can be easily and quickly performed in inferior oblique overaction cases and has high success rates in cases with a small-to-moderate angle of deviation.

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Section: Discussionmentioning

confidence: 95%

Inferior oblique overaction: The results of myectomy in cases with a primary position vertical deviation less and more than 20 prism diopters

Sefi-Yurdakul

Gucyetmez

2020

Middle East Afr J Ophthalmol

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“…The finding that isolated weakening of the antagonist IOM was largely ineffective in reducing the excyclotorsion associated with these children's torticollis/head-tilt, contrasted with the success of primary IOM weakening when correcting symptomatic vertical diplopia present in older children and adults (Coyle & MacEwan 2013;Kaeser, Klainguti & Kolling 2012;Raoof & Burke 2016). Indeed, Kaeser, Klainguti & Kolling (2012) concluded that inferior oblique recession (IOR) alone was very successful for managing congenital superior oblique palsy in adults (mean age 36 years), but a combined inferior oblique recession and superior oblique tuck should be considered in adults when the vertical deviation was particularly large in downgaze.…”

Section: Discussionmentioning

confidence: 99%

How Successful is Combined Superior and Inferior Oblique Muscle Surgery in Young Children with Superior Oblique Underaction Presenting in Infancy with a Severe Head Tilt?

Littlewood

Burke

2021

British and Irish Orthoptic Journal

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Background/Objective: To evaluate the success of combining ipsilateral inferior and superior oblique muscle surgery in young children with congenital unilateral superior oblique under action who present in infancy with a large socially noticeable head-tilt. Methods: A consecutive retrospective case series of young children was analysed. The success of surgery in eliminating the head-tilt was evaluated by pre-and postoperative ocular motility assessment focusing on the vertical misalignment in primary position and downgaze, the magnitude of the head-tilt in degrees and the status of the superior oblique tendon. Results: Five children had a mean age at first surgery of 41 (range 25-63) months, a mean primary position vertical deviation of 26 (25-30) prism dioptres, a head-tilt of 30 (20-35) degrees and a mean post-operative follow up of 24 (8-43) months. While there was a uniform surgical plan, nonetheless each operation required individualisation based on a spectrum of per-operative superior oblique tendon findings. The head tilt was eliminated in 40% and reduced in the remainder, to a mean of 7 (0-18) degrees and with a mean post-operative primary position vertical misalignment of 3 (range 0-10) and of 10 (range 0-40) prism dioptres in downgaze. Conclusion: Combined, ipsilateral oblique muscle surgery reduced the severe head tilt and primary position alignment to a psychosocially and functionally acceptable level. For the majority, the outcome was stable or associated with further decremental improvement. A persistent downgaze vertical tropia occurred in children with macroscopically abnormal superior oblique tendons but these cases were not identifiable clinically pre-operatively.

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Efficacy of isolated inferior oblique anteriorization on large-angle hypertropia associated with unilateral superior oblique palsy

Nabie

Manouchehri

Babaei

2020

Journal of American Association for Pediatric Ophthalmology and

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Isolated inferior oblique myectomy for vertical deviations of at least 20 prism diopters in the primary position

Cited by 8 publications

References 6 publications

Inferior oblique overaction: The results of myectomy in cases with a primary position vertical deviation less and more than 20 prism diopters

Inferior oblique overaction: The results of myectomy in cases with a primary position vertical deviation less and more than 20 prism diopters

How Successful is Combined Superior and Inferior Oblique Muscle Surgery in Young Children with Superior Oblique Underaction Presenting in Infancy with a Severe Head Tilt?

Efficacy of isolated inferior oblique anteriorization on large-angle hypertropia associated with unilateral superior oblique palsy

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