Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2026
The effect of inferior oblique weakening on vertical deviation in contralateral gaze.
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Suresh Basil, Kalyana Anish, Dosanjh Surinder, Jain Saurabh
Аннотация
PURPOSE: To quantify the effect of isolated, unilateral inferior oblique (IO) weakening procedures on reducing the preoperative contralateral vertical deviation.
METHODS: We performed a retrospective cohort study of 59 patients who underwent unilateral IO weakening. Postoperative vertical deviation was modeled with analysis of covariance, with surgical technique as a fixed factor and baseline vertical deviation, age, and weeks since surgery as covariates. Primary outcomes were adjusted postoperative contralateral deviations in elevation, horizontal gaze, and depression; secondary outcomes, ipsilateral deviations.
RESULTS: Mean patient age was 42.2 ± 21.1 years. Superior oblique palsy was the most common indication for surgery (48%). Mean baseline contralateral vertical deviations were approximately 17Δ-18Δ across contralateral elevation, horizontal gaze, and depression. Mean follow-up was 2.7 months, with estimated marginal means corresponding to approximately 11-14 weeks. Adjusted postoperative contralateral deviations were 6.48Δ (95% CI, 4.49-8.48) in elevation, 7.20Δ (95% CI, 5.16-9.23) in horizontal gaze, and 5.96Δ (95% CI, 3.73-8.19) in depression, representing descriptive reductions of approximately 10Δ-12Δ. Ipsilateral adjusted residual deviations were 5.86Δ, 5.80Δ, and 5.50Δ for elevation, horizontal gaze and depression, respectively. Baseline deviation was the dominant predictor of outcome (partial η2 up to 0.77), whereas follow-up time and age were not associated with postoperative deviation.
CONCLUSIONS: In our small study cohort, isolated unilateral IO weakening resulted in moderate early reductions in contralateral vertical deviation across elevation, horizontal gaze, and depression, with smaller ipsilateral changes.
METHODS: We performed a retrospective cohort study of 59 patients who underwent unilateral IO weakening. Postoperative vertical deviation was modeled with analysis of covariance, with surgical technique as a fixed factor and baseline vertical deviation, age, and weeks since surgery as covariates. Primary outcomes were adjusted postoperative contralateral deviations in elevation, horizontal gaze, and depression; secondary outcomes, ipsilateral deviations.
RESULTS: Mean patient age was 42.2 ± 21.1 years. Superior oblique palsy was the most common indication for surgery (48%). Mean baseline contralateral vertical deviations were approximately 17Δ-18Δ across contralateral elevation, horizontal gaze, and depression. Mean follow-up was 2.7 months, with estimated marginal means corresponding to approximately 11-14 weeks. Adjusted postoperative contralateral deviations were 6.48Δ (95% CI, 4.49-8.48) in elevation, 7.20Δ (95% CI, 5.16-9.23) in horizontal gaze, and 5.96Δ (95% CI, 3.73-8.19) in depression, representing descriptive reductions of approximately 10Δ-12Δ. Ipsilateral adjusted residual deviations were 5.86Δ, 5.80Δ, and 5.50Δ for elevation, horizontal gaze and depression, respectively. Baseline deviation was the dominant predictor of outcome (partial η2 up to 0.77), whereas follow-up time and age were not associated with postoperative deviation.
CONCLUSIONS: In our small study cohort, isolated unilateral IO weakening resulted in moderate early reductions in contralateral vertical deviation across elevation, horizontal gaze, and depression, with smaller ipsilateral changes.