Surgery on the Inferior Oblique Muscle

Nawratzki, I

doi:10.1007/978-3-540-32704-2_11

Cited by 2 publications

(4 citation statements)

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“…The weakening procedures of ipsilateral overacting IO muscle include medial myectomy, anterior alteration and anterolateral transfixation. [1][2][3] We report a case of superior oblique palsy with IOOA corrected by antero-medial transposition of IO.…”

Section: Introductionmentioning

confidence: 96%

Antero-medial Transposition of Inferior Oblique for a Superior Oblique Palsy: A Case Report

Kadir¹,

Chowdhury²

2023

pak J Ophthalmol

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A 29-year-old female presented with large-angle hypertropia, and small-angle exotropia associated with inferior oblique over action (IOOA). Orthoptic examination revealed right hypertropia of 35 PD with 12 PD of exotropia by prism cover test. There was no restriction of ocular motility, but we found right inferior oblique over action. She had a head tilt of approximately 30 degrees towards the left side. The Patient underwent "Antero-medial transposition of the inferior oblique" to correct strabismus. After surgery, she was orthotropic in the primary position with an average head-chin posture. Single approach surgery like the antero-medial transposition with an overacting inferior oblique may help to correct the large angle hypertropia associated with superior oblique (SO) palsy.

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Section: Introductionmentioning

confidence: 96%

Antero-medial Transposition of Inferior Oblique for a Superior Oblique Palsy: A Case Report

Kadir¹,

Chowdhury²

2023

pak J Ophthalmol

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“…Nevertheless, these procedures are also intended to correct the primary gaze hypertropia as well as excyclotorsion. [1][2][3][4][5][6][7] In clinics, the inferior oblique muscle overaction is frequently encountered in infantile esotropes, where it can be witnessed in up to 70% of the cases, 1 such overactions can also be witnessed in superior oblique palsy, comitant horizontal deviations, dissociated vertical deviation, and others. To treat it, in milder grades (usually 1+), we prefer 8-10 millimeters of inferior oblique recession, and in grade 2+ we prefer 12-14 millimeters of recessions or Elliott and Nankins procedure.…”

Section: Introductionmentioning

confidence: 99%

“…In grades 3+ and 4+, we prefer the anteriorization procedure or the antero-nasal transposition procedure, where the primary gaze hypertropia as well as the excyclotorsion are taken care of. Apart from these, myectomy and many other procedures have been described in literature, 3,4,[6][7][8] however we rarely prefer them.…”

Section: Introductionmentioning

confidence: 99%

“…All these techniques are able to cure the over-elevation in adduction, and also they are able to collapse the associated "V" pattern strabismus, 1,5,7 however, the anteriorization procedures are quite famous for their anti-elevation effect, or the antielevation syndrome (as described by Kushner). 9,10 Where, due to anatomical changes in the inferior oblique muscle course and its associated neurovascular bundle the vertical rotation is limited, clinically, it can be witnessed as elevation deficit in abduction as well as in primary gazes (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

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Novel Inferior Oblique Muscle Y Splitting Procedure to Minimize the Anti-Elevation Syndrome: A Pilot Study

Pujari¹,

Modaboyina²,

Thangavel³

et al. 2022

OPTH

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To describe novel Y splitting procedure of inferior oblique muscle to mitigate the anti-elevation syndrome. Methods: A pilot, prospective interventional study was undertaken to assess the effect of inferior oblique muscle Y-splitting in patients with unilateral 3+ or more overaction. To correct primary gaze hypertropia and the excyclotorsion, a Y-splitting procedure was performed (along with routine horizontal muscle surgery as per the deviation) in 14 subjects. The effect of surgery was assessed at baseline and at 6 months post-intervention. Results: The mean age of 14 subjects was 25.14±7.70 years. The mean pre-operative hypertropia, excyclotorsion and inferior oblique muscle over-action was 18.42±3.50 PD, 14.14±2.65 degrees, and +3.21±0.42 respectively. Following surgery, this was reduced to 1.57 ±1.74 PD of residual hypertropia (a net correction of 16.85±2.31 PD, p = 0.005), 3.85±1.46 degrees of residual excyclotorsion (a net correction of 10.28±1.72 degrees, p < 0.05), and +0.28±0.46 of residual inferior oblique over-action (a net correction ~+3) at the end of 6 months. Amongst fourteen patients, three patients still experienced residual/variable anti-elevation effect, and during the study period none of them experienced any adverse event and none of them required any additional surgeries. Conclusion: While anteriorizing the inferior oblique muscle to correct primary gaze hypertropia and the excyclotorsion, a novel "Y splitting" procedure can be followed to achieve the desired results with mitigated anti-elevation effect.

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Surgery on the Inferior Oblique Muscle

Cited by 2 publications

References 0 publications

Antero-medial Transposition of Inferior Oblique for a Superior Oblique Palsy: A Case Report

Antero-medial Transposition of Inferior Oblique for a Superior Oblique Palsy: A Case Report

Novel Inferior Oblique Muscle Y Splitting Procedure to Minimize the Anti-Elevation Syndrome: A Pilot Study

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