Outcome of unilateral inferior oblique recession

The aim of this study was to analyze the outcome of unilateral inferior oblique (IO) recession in patients with unilateral or asymmetrical IO overaction in terms of effectiveness, stability, and undesired effects.

Fifteen patients with nonparalytic strabismus who underwent unilateral IO recession for unilateral or asymmetric IO overaction and horizontal muscle surgery were included in this study. Nine patients demonstrated asymmetric bilateral IO overaction, whereas 6 had unilateral overaction. All patients underwent IO recession to the Scheie Parks point in one eye, along with conventional horizontal muscle surgery. Clinical outcome assessment included changes in oblique muscle dysfunction in both eyes. Changes in horizontal deviation, V pattern, vertical deviation, and excyclotorsion were also studied.

Satisfactory outcome in terms of oblique muscle function, V pattern, vertical deviation, and cyclodeviation was achieved in all patients with unilateral IO overaction and 7 (77%) patients with bilateral IO overaction. Increased IO overaction in the other eye was noted in 2 patients. Satisfactory outcome in patients with bilateral overaction was related to degree of asymmetry in IO overaction between the 2 eyes.

Unilateral IO recession is effective in patients with unilateral IO overaction and selected patients with largely asymmetrical bilateral IO overaction.