Inferior oblique retro-equatorial myopexy: An alternative weakening

To describe an alternative surgical approach to treat inferior oblique overaction, and report the first results of this technique.

A total of 6 consecutive eyes of 6patients with primary or secondary inferior oblique overaction underwent inferior oblique retro-equatorial myopexy under general anaesthesia. The primary outcomes measured were the postoperative vertical deviation in the field of action of the inferior oblique muscle, and the intra- and postoperative surgical complications. Final results were evaluated at six-months after surgery.

The patient population consisted of 3girls and 3boys aged between 4 and 7years old. The mean preoperative inferior oblique overaction was 34°±4.6°, equivalent to 3+. Inferior oblique overaction was reduced in all patients with a mean reduction of 28°±1.98°, and the mean postoperative deviation was 6°±2.84°. Total success was achieved in four out of six eyes, and only one case remained under-corrected. No intra- or postoperative complications were reported.

Inferior oblique retro-equatorial myopexy is an alternative surgical approach for inferior oblique overaction. It is an efficient, safe, and reversible technique that could be used in cases of inferior oblique overaction between 2+ to 3+.