Efficacy of inferior oblique belly transposition combined with inferior oblique recession for asymmetric inferior oblique overaction.

OBJECTIVE

To evaluate the efficacy of inferior oblique belly transposition (IOBT) combined with inferior oblique (IO) recession in treating bilateral asymmetric inferior oblique overaction (IOOA).

METHODS

A retrospective review. The data of 14 patients who underwent IOBT on the mild side of IOOA and IO recession on the severe side for bilateral asymmetric IOOA were analyzed retrospectively. The main surgical results including the correction of IOOA, hypertropia, horizontal deviation, V pattern, and fovea-disc angle (FDA) were observed.

RESULTS

The IOBT corrected the preoperative grade (+1.86 ± 0.53) of the mild-side IOOA to a postoperative grade (+0.07 ± 0.27; p < 0.001), and the severe-side IOOA was corrected from a grade of +3.14 ± 0.53 to a postoperative grade of +0.14 ± 0.36 by the IO recession (p < 0.001). The vertical deviation at distance in the primary position was decreased from 8.43 ± 4.05 PD preoperatively to 1.21 ± 1.48 PD postoperatively (p < 0.001). The mean V pattern was 25.00 ± 11.62 PD preoperatively and 3.18 ± 2.18 PD postoperatively (p < 0.001). The mean preoperative FDA on the side where IOBT was performed was -10.47 ± 5.85 degrees, and the postoperative FDA was -7.82 ± 6.42 degrees (p = 0.023). The mean FDA on the side with IO recession was -11.05 ± 5.14 degrees before surgery and -6.09 ± 4.52 degrees after surgery (p = 0.001). The overall success rate was 71.4% (10 of 14).

CONCLUSIONS

IOBT combined with IO recession is effective and safe in eliminating hypertropia, V pattern, and extorsion with bilateral asymmetric IOOA.