[Recessed inferior rectus syndrome: surgical exploration and pathophysiology]

Progressive overcorrection after inferior rectus recession may occur in 10%-40% of cases, whatever the surgical indication, whatever the technique. The clinical features are hypertropia, inferior rectus underaction, and lid retraction.

The anatomy of the inferior rectus during surgical exploration is described in 11 cases initially operated on for different types of strabismus.

Several types of slippage and several types of excessive fibrosis in the area of the inferior rectus are described.

Our surgical data are compared to the pathophysiological hypothesis described in the literature. Preventive measures and curative treatment are discussed.

Even a better understanding of the physiopathogenesis of overcorrection after inferior rectus recession could not prevent its occurrence, despite upgraded surgical technique. There is no consensual opinion on how to prevent and cure these overcorrections. Associating oculomotor surgery and lid surgery is an interesting direction for new research.