Inferior oblique recession: an efficient technique

We describe a novel, simple, rapid technique for inferior oblique recession.

Access to the muscle is gained through a peripheral radial conjunctival incision midway between the lateral and inferior recti. The anterior edge of the inferior oblique muscle is identified coursing parallel to the limbus on the undersurface of Tenon's capsule, at the apex of the exposure. A locking vicryl suture is placed 1 mm from the muscle insertion. The insertion is cut along the globe under direct vision and attached to the sclera 2 mm posterior and lateral to the lateral border of inferior rectus. The conjunctiva is closed with interrupted vicryl sutures.

The technique described allows direct visualization of the muscle throughout the procedure. In addition, bleeding is usually avoided and tissue manipulation is minimized, thus ensuring good visibility throughout the procedure and minimizing the risk of scarring.

Severence of the inferior oblique muscle insertion under direct vision, facilitated by good traction of the globe in the same meridian, affords a rapid minimally invasive approach to inferior oblique recession.