Fat adherence syndrome following inferior oblique surgery: Treatment and outcomes

Abstract

PurposeDescribe surgical treatment and results in a group of patients diagnosed and operated on of fat adherence syndrome following inferior oblique surgery.Patients, material and methodsRetrospective study of 6 cases diagnosed and treated of fat adherence syndrome following inferior oblique surgery. Mean age was 24.67 years (range, 5–41), 3 males, 5 unilateral and 1 bilateral. Mean vertical deviation was 16.16 pd (range, 4–25). Esotropia was associated in 4 cases, diplopia in other 2, and anomalous head posture in 3. A good outcome was considered when the final deviation was less than 10 pd, with mild limitation of elevation, without anomalous head posture, and a negative duction forced test.ResultsThe final vertical deviation was 6.83 pd (range, 0–14). A 2–4 mm inferior rectus recession was performed on 4 patients associated to an inferior oblique surgery/exploration. All patients were operated on once, except 1 case. A good outcome was achieved in 3 patients. Anomalous head posture was resolved in 2 of 3 cases. Diplopia resolved after surgery. Only one case achieved orthophoria. Mean evolution time was 34.83 months (range, 6–78).ConclusionIn the treatment of the fat adherence syndrome, an inferior rectus recession is recommended, associated to inferior oblique exploration or surgery. A good favorable outcome was only achieved in half of the cases with surgical treatment. Limitation of elevation could not be completely resolved in any of the patients.

Does Preoperative Diplopia Determine the Incidence of Postoperative Diplopia After Repair of Orbital Floor Fracture? An Institutional Review

“…Also, no treatment modality is known to alleviate ocular restriction in FAS. 53 Merino et al 54 has recommended exploration of the inferior oblique muscle to release adhesions and reposition the inferior oblique in an attempt to alleviate the symptoms. Their study was, however, limited by the number of subjects.…”

“…Only 4 patients underwent inferior oblique repositioning, although 3 of the patients had favorable outcomes. 54…”