Surgical Management of Primary Inferior Oblique Muscle Overaction: A Subgroup-Specific Surgical Approach

Area of Science:

• Ophthalmology
• Strabismus Surgery

Background:

• Primary inferior oblique muscle overaction is a common cause of strabismus.
• Accurate diagnosis and appropriate surgical intervention are crucial for successful management.

Purpose of the Study:

• To evaluate the surgical outcomes of recession and myectomy procedures.
• To assess the efficacy of these surgical techniques in patients with primary inferior oblique muscle overaction.

Main Methods:

• Retrospective analysis of 94 patients with primary inferior oblique muscle overaction.
• Classification of patients into low-grade (recession) and high-grade (myectomy) hyperfunction groups.
• Concurrent horizontal muscle surgery for patients with horizontal misalignment.

Main Results:

• Surgical success rates were high: 96.8% for recession and 97.4% for myectomy.
• Recession and myectomy procedures showed minimal residual inferior oblique hyperfunction.
• Approximately 25% of patients with unilateral overaction developed contralateral overaction post-surgery.

Conclusions:

• Both recession and myectomy are effective surgical options for primary inferior oblique hyperfunction.
• These procedures offer favorable outcomes with low complication rates when tailored to patient severity.
• Careful patient selection is key to successful surgical management of inferior oblique overaction.