Uses of the inferior oblique muscle in strabismus surgery

Dao, Lori; Felius, Joost

doi:10.4103/0974-9233.159723

Cited by 34 publications

(20 citation statements)

References 49 publications

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“…Inferior oblique myectomy and recession are the most commonly performed procedures to weaken inferior oblique overaction. 1 In patients with small hypertropias in the primary gaze position (< 5 prism diopters [PD]), both procedures carry the risk of overcorrecting small vertical deviations. 2 Z-myotomy has been reported as an alternative surgical option for mildly overacting inferior oblique muscles associated with small hypertropias [3][4][5] ; however, it is still not widely used since it was originally described more than 60 years ago.…”

Section: Introductionmentioning

confidence: 99%

Inferior Oblique Belly Transposition for Small Angle Hypertropia With Inferior Oblique Overaction: A Pilot Study

Yang¹,

Guo²,

Tien³

2018

J Pediatr Ophthalmol Strabismus

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Section: Introductionmentioning

confidence: 99%

Inferior Oblique Belly Transposition for Small Angle Hypertropia With Inferior Oblique Overaction: A Pilot Study

Yang¹,

Guo²,

Tien³

2018

J Pediatr Ophthalmol Strabismus

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“…It passes posteriorly, superiorly, and laterally between the inferior orbital wall and the inferior rectus muscle, inserting in the lower edge of the lateral rectus muscle with a concave arc. e anterior part of insertion is 10 mm far from the lower ending of the lateral rectus muscle, the posterior part of insertion is 4.2 mm far from the optic nerve, and only 2.2 mm away from the fovea of the macula [8]. e contact curve between the IO muscle and the eyeball is 15 mm, which is the longest one of all extraocular muscles, and it might be responsible for IO-E.…”

Section: Discussionmentioning

confidence: 97%

Clinical Manifestations, Diagnosis, and Surgery of Inferior Oblique Muscle Ectopia

Zhang

Min

Wang

et al. 2020

Journal of Ophthalmology

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Objectives. To summarize the clinical manifestations, diagnosis, treatment, and prognosis for inferior oblique muscle ectopia (IO-E). Subjects and Methods. Patients diagnosed with IO-E during strabismus surgery from March 2017 to September 2018 were included in this retrospective, cross-sectional study. All patients received preoperative Krimsky test, synoptophore, cycloplegia refraction, fundus torsion, and other strabismus-related specific tests. The anatomic variations of IO-E were always discovered during surgical procedure. Postoperative eye position and binocular visual function (BVF) were all reviewed in early days after operation. Results. A total of 7 patients were enrolled in this study with an average age of 6.4 ± 3.8 yrs. They all presented with significant exotropia and unilateral (or bilateral) overelevation in adduction (OEA). No compensatory head position was detected. Some of them had vertical deviation, V pattern, or excyclotropia, which were indicated by fundus torsion. Monocular or binocular IO-E was distinguished during the surgery, and it could be classified into two types according to its anatomic features. In surgery, the ectopic IO muscle bundle was restored, and different IO weakening methods were employed. Meanwhile, the horizontal deviation was also corrected according to the preoperative examination. Eyes of all patients were properly aligned in the primary position after surgery. Varying degrees of BVF appeared in 3 cases. Conclusions. IO-E is a rare congenital dysplasia variation of the extraocular muscle, which could appear as inferior oblique overaction. It is difficult to diagnose before surgery, and weakening the overactive ectopic inferior oblique was required for better prognosis if this condition was confirmed during surgery.

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“…lnferior oblique muscle (IO) differs in its anatomical structure from other extraocular muscles (EOM), this made many researchers to find out the correlation between the muscle ultrastructural changes and the clinical effect on its action. 1 The muscle arises from anterior part of the orbital floor near to the margin and inserts in the inferolateral quadrant of the sclera posterior to equator and in-between lateral and inferior rectus muscles. 2 Overaction of the IO muscle produces elevated eye in adduction position.…”

Section: Introductionmentioning

confidence: 99%

Electron Microscopic and Histopathological Study of the Overacting Inferior Oblique Muscle of the Human Eye

Kandeel

Desouki

Sagheer

et al. 2021

Al-Azhar International Medical Journal

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Background: Inferior oblique muscle overaction is a common disorder that has a correlation with the anatomical changes of the muscle itself. The changes differ according to the grade of the overaction. Objective: To correlate between the histopathological alternations of the inferior oblique muscle and the different degrees of clinical overaction. Patients and methods: Ten biopsies from inferior oblique muscles were taken during the surgery of strabismus after determining the clinical degree of the overaction. One muscle biopsy was taken during enucleation surgery and considered as a control. All biopsies were examined by light and transmission electron microscopes. Results: By light microscopy, grade II and grade III inferior oblique overaction showed many histopathological findings as muscle fibers degeneration, variable size of muscle fibers, nerve bundles hypertrophy and fibro-fatty infiltrations. Grade III inferior oblique overaction showed fibrosis of perimysium and endomysium, mononuclear infiltration and fatty infiltration. By transmission electron microscopy the muscle fibers showed increased mitochondrial number and mitochondrial variability in shape and size, also showed increased vacuoles and fat droplets. Conclusion: Histopathological alternations in the inferior oblique muscle correlate to the clinical grades of the muscle overaction.

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Uses of the inferior oblique muscle in strabismus surgery

Cited by 34 publications

References 49 publications

Inferior Oblique Belly Transposition for Small Angle Hypertropia With Inferior Oblique Overaction: A Pilot Study

Inferior Oblique Belly Transposition for Small Angle Hypertropia With Inferior Oblique Overaction: A Pilot Study

Clinical Manifestations, Diagnosis, and Surgery of Inferior Oblique Muscle Ectopia

Electron Microscopic and Histopathological Study of the Overacting Inferior Oblique Muscle of the Human Eye

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