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Quantification (grading) of inferior oblique muscle recession for V-pattern strabismus
K M Monteiro de Carvalho1, N Minguini, F J Dantas
1Department of Ophthalmology, State University of Campinas, Campinas, Brazil.
Purpose:
To determine the effectiveness of grading such surgery according to the magnitude of the V pattern and inferior oblique muscle overaction (IOOA).
Methods:
We retrospectively reviewed all 53 cases we operated since 1984 for V pattern with IOOA, who had undergone graded inferior oblique recession, recessed according to the anatomical recession table of Apt and Call, ranging from 8mm for V pattern of 12 PD with +1 IOOA to 12mm for 30+ PD with +3 IOOA.
Results:
A "satisfactory outcome" (defined as = V pattern of 8 PD or less) was observed in 75% of the cases with a preoperative V pattern less than 20 PD, in 70% of those with a preop' V pattern between 20 PD and 29 PD, and in 57% of those with a preop' V pattern greater than 29 PD. There were no overcorrections. All unsatisfactory outcomes were undercorrections.
Conclusions:
The principle of grading this surgery is supported and affirmed by these results. However, the results also suggest a need to increase the amount of surgery for all categories and add anterior transposition for larger V patterns.