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Inferior Oblique Weakening and Abnormal Head Position: Controlled Myotomy versus Recession.

R Migliorini1, R Malagola1, A M Comberiati1

  • 1Department of Sense Organs, "Sapienza" University of Rome, Rome, Italy.

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|December 27, 2016
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Summary

Controlled Myotomy offers a valid alternative to Recession for treating inferior oblique (IO) muscle hyperfunction and abnormal head position (AHP), achieving better long-term AHP resolution.

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Area of Science:

  • Ophthalmology
  • Strabismus Surgery
  • Pediatric Ophthalmology

Background:

  • Inferior oblique (IO) muscle hyperfunction can lead to abnormal head position (AHP).
  • Surgical correction is often necessary to address these conditions.

Purpose of the Study:

  • To compare surgical outcomes of Recession versus (thread) Controlled Myotomy for IO muscle hyperfunction with AHP.
  • To evaluate the efficacy and long-term results of each surgical technique.

Main Methods:

  • A randomized controlled trial involving 20 patients with medium-high IO hyperfunction and AHP.
  • Patients were divided into two groups: 10 underwent traditional Recession (Group A) and 10 underwent Controlled Myotomy (Group B).
  • Outcomes were assessed via ophthalmological and orthoptic examinations after one year.

Main Results:

  • After one year, 80% of Group A (Recession) achieved orthophoria, but 40% had residual AHP.
  • In Group B (Controlled Myotomy), 20% achieved orthophoria with complete AHP resolution.
  • Group B also showed a higher rate of small vertical deviation with small AHP (80%) compared to Group A (20%).

Conclusions:

  • Thread Controlled Myotomy is a viable alternative to Recession for treating IO hyperfunction with AHP.
  • Controlled Myotomy demonstrated superior long-term resolution of AHP compared to Recession.
  • Fewer intrasurgical risks are associated with Controlled Myotomy.