A Randomized Clinical Trial Comparing Myectomy and Recession in the Management of Inferior Oblique Muscle Overaction

• Published in: Journal of pediatric ophthalmology and strabismus Vol. 48; no. 6; pp. 375 - 380
• Main Authors: Rajavi, Zhale, Molazadeh, Arman, Ramezani, Alireza, Yaseri, Mehdi
• Format: Journal Article
• Language: English
• Published: United States SLACK INCORPORATED 01-11-2011
• Subjects: Adolescent; Adult; Child; Child, Preschool; Double-Blind Method; Eye Movements - physiology; Female; Humans; Male; Methods; Ocular Motility Disorders - surgery; Oculomotor Muscles - surgery; Ophthalmologic Surgical Procedures - methods; Regression analysis; Standard deviation; Strabismus - surgery; Studies; Surgical techniques; Treatment Outcome; Vision, Binocular - physiology; Visual Acuity - physiology; Young Adult
• ISSN: 0191-3913; 1938-2405
• DOI: 10.3928/01913913-20110118-04

Purpose:
It is still not clear whether inferior oblique recession or inferior oblique myectomy is a better option for weakening inferior oblique overaction (IOOA). The aim of this study was to compare the effect of these two methods on IOOA.
Methods:
Patients who were candidates for surgical management of IOOA were randomly assigned to either IO myectomy or recession. Complete ophthalmic examinations were performed before surgery. In the myectomy group, 5 mm was excised from the inferior temporal region of IO muscle(s). In the recession group, the IO muscle was disinserted and subsequently sutured to a point 2 mm lateral and 4 mm posterior to the insertion of the inferior rectus muscle on the temporal side. Satisfactory results were defined as an IO function of grade 0 or 1+ at 3 months postoperatively.
Results:
The study included 50 patients (82 eyes) with a mean age of 12.3 ± 5.9 years (range: 3 to 32 years). Both methods were effective on the weakening of IOOA (The study included 50 patients (82 eyes) with a mean age of 12.3 ± 5.9 years (range: 3 to 32 years). Both methods were effective on the weakening of IOOA (
P
< .001). The rate of satisfactory results was similar in both groups (
P
= .686). The rate of residual IOOA and IO underaction did not differ between the two groups. Regarding the changes of horizontal or vertical deviations, V pattern, and dissociated vertical deviation, there was no statistically significant difference between the two groups.
Conclusion:
For treatment of IOOA, both IO myectomy and recession can be used with similar success rate.