Aim To determine the effectiveness of grading such surgery according to the degree of inferior oblique muscle overaction (IOOA).
METHODS We reported all 64 cases we operated since 2009 for strabimus with double inferior oblique overaction with IOOA, who had undergone graded inferior oblique recession, recessed according to manegement of inferior oblique overaction by Kenneth W Wright , using the temporal border and the insertion of the inferior rectus as the reference points to locate the new insertion. Range from IOOA +1 to +4 and including DVD with IOOA. At the same time we corrected horizontal deviation.
RESULTS A total of 128 eye surgeries on 64 patients were analyzed. 28 cases were asymmetry IOOA with V-pattern, 23 cases were symmetry with V-pattern and 13 cases were asymmetry IOOA with DVD. We observed favorable results ("statistically significant") concerning the reduction of the IO overaction or V incomitance . In 62% (79 eyes) the IO function was normalized, in 12% (15 eyes) there was a reduction to -1 (underaction) and in 26% (34 eyes) there was a reduction, but there still remained a +1 overaction. In 82% of the patients got a "satisfactory" outcome of the V pattern, defined as a residual incomitance less than 10 PD and . In 78% of patients with DVD and IOOA got "satisfactory" outcomes, defined as vertical deviation less than 5PD .
Conclusions In this group of patients with strabismus with double inferior oblique overaction, graded anterior transposition based on Wright's technique showed satisfactory results ("statistically significant") in correcting the V incomitance and DVD and normalizing or reducing the IO overaction, especially in strabismus with asymmetry IOOA. |
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