Surgical Outcome of Inferior Oblique Myectomy versus Recession–Anteriorization in the Treatment of Inferior Oblique Overaction

Abstract

Purpose

This study aimed to compare the surgical outcome of inferior oblique myectomy, IOM versus inferior oblique recession–anteriorization, IORA in the treatment of inferior oblique overaction, IOOA.

Patients and Methods

A retrospective chart review was performed over a 12-year period, from 2009 to 2021. Eighty-nine patients diagnosed with IOOA who underwent IOM or IORA were included. The primary outcome was postoperative residual IOOA (grade 0 to +4) and percentage favorable outcome, defined as IOOA grade ≤1+ at 6 months post operation, in each group. The outcomes were compared between the two surgical procedures (IOM and IORA). The secondary outcome was the percentage of postoperative anti-elevation syndrome cases for each surgical procedure.

Results

The median age at the time of surgery was 10.50 years (interquartile range, IQR: 2.83 to 28.33) in the IOM group and 5.08 years (IQR: 2.75 to 29.42) in the IORA group. The favorable outcome at 6 months was 90.91% in the IOM group, which was lower than the 95.74% in the IORA group but the difference was not statistically significant (P-value = 0.390, 95% CI: 0.07–2.82). The only surgical complication, anti-elevation syndrome, was detected in 3.77% of IOM cases and 5.80% of IORA cases, with an odds ratio of 0.64 on comparing the IOM group to the IORA group (P-value = 0.611, 95% CI: 0.11–3.62).

Conclusion

These two weakening procedures are effective for treating IOOA. Although IORA seemed slightly superior to IOM in terms of favorable outcomes, the difference was not statistically significant. Moreover, the myectomy procedure was easier, was less time-consuming, had a lower risk of globe perforation and presented fewer complications such as anti-elevation syndrome.

Keywords:

• inferior oblique overaction
• IOOA
• inferior oblique myectomy
• IOM
• inferior oblique recession and anteriorization
• IORA

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Surgical Outcome of Inferior Oblique Myectomy versus Recession–Anteriorization in the Treatment of Inferior Oblique Overaction [Corrigendum]

Abbreviations

AHP, Anomalous Head Posture; BCVA, Best Corrected Visual Acuity; ET, Esotropia; IO, Inferior Oblique; IOM, Inferior Oblique Myectomy; IOOA, Inferior Oblique Overaction; IORA, Inferior Oblique Recession and Anteriorization; LogMAR, Logarithm of the Minimum Angle of Resolution; XT, Exotropia; SO, Superior Oblique.

Ethics and Consent to Participate

This study was approved by the Human Research Ethics Committee of the Faculty of Medicine, Ramathibodi Hospital, Mahidol University and adhered to the Declaration of Helsinki. Due to the retrospective nature of the review, the authors confirm that the patient data was anonymized and maintained with confidentiality.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

The authors declare that no funding was received for this study.