The Effect of Reoperation in Inferior Oblique Overaction

Sung Hyuk Moon; Myung Mi Kim

doi:10.3341/jkos.2008.49.6.967

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Moon and Kim: The Effect of Reoperation in Inferior Oblique Overaction

Original Article

J Korean Ophthalmol Soc 2008;49(6):967-972.

Published online: 8 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.6.967

The Effect of Reoperation in Inferior Oblique Overaction

Sung Hyuk Moon, M.D., Myung Mi Kim, M.D., Ph.D.

Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea

Address reprint requests to Myung Mi Kim, M.D., Ph.D. Department of Ophthalmology, Yeungnam University College of Medicine #317-1 Daemyung-dong, Nam-gu, Daegu 705-717, Korea Tel: 82-53-620-3441, Fax: 82-53-626-5936, E-mail: mmk@med.yu.ac.kr

12 February 2008 Accepted 29 June 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the efficacy of re-recession or extirpation of inferior oblique (IO) muscle in recurrent or undercorrected IO overaction (IOOA).

Methods

We reviewed the records of 26 patients (33 eyes) with the recurrent or undercorrected IOOA after the graded recession of IO muscle, who underwent re-recession or extirpation of IO muscle, and was followed up for at least 6 months. We performed extirpation of IO muscle overacting larger than +2 after 14 mm recession of IO muscle or larger than +3 after 10 mm recession of IO muscle. In case of +2 IOOA after 10 or 8 mm recession of IO muscle, we carried out 14 mm re-recession of IO muscle. IOOA under +1 was defined as a successful case after re-operation.

Result

Thirty one of 33 eyes (93.9%) were corrected successfully after re-operation; 24 eyes with extirpation of IO muscle (96.0%) and 7 eyes with 14 mm re-reccession of IO muscle (87.5%) were successful.

Conclusion

One of the advantages of graded recession of IO muscle is that additional re‐ recession or extirpation of IO muscle can be preformed if needed. Extirpation or 14 mm re-recession of IO muscle was effective re operation procedure to correct a recurred or undercorrected IOOA.

Keywords: Extirpation, Inferior oblique overaction, Re-operation, Re-reccession

References

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Table 1.

Age, sex, laterality, and inferior oblique overaction in patients undergoing inferior oblique muscle surgery

Case	Age (year)	Sex	Laterality	Preoperative IOOA^*	e 1st surgery	IOOA just before 2nd OP^†	2nd surgery	Final IOOA
1	7	F^‡	OD^∏	+4	IO REC^** 14	+3	IO EXT^††	+1
2	6	M^§	OS^#	+4	IO REC 14	+3	IO EXT	0
3	5	F	OS	+4	IO REC 14	+3	IO EXT	0
4	7	F	OD	+4	IO REC 14	+3	IO EXT	0
5	7	F	OS	+4	IO REC 14	+3	IO EXT	0
6	3	M	OD	+3	IO REC 14	+4	IO EXT	0
7	6	F	OD	+4	IO REC 14	+4	IO EXT	0
8	7	F	OD	+4	IO REC 14	+2	IO EXT	0
9	8	M	OD	+3	IO REC 10	+3	IO EXT	-1
10	6	M	OD	+3	IO REC 10	+3	IO EXT	0
11	3	F	OS	+4	IO REC 14	+4	IO EXT	0^§§
12	5	F	OS	+4	IO REC 14	+3	IO EXT	0
13	3	F	OS	+4	IO REC 14	+3	IO EXT	0
14	4	F	OS	+4	IO REC 14	+4	IO EXT	+2
15	6	F	OS	+4	IO REC 14	+3	IO EXT	+1
16	7	F	OS	+3	IO REC 10	+3	IO EXT	0
17	5	M	OS	+4	IO REC 14	+2	IO EXT	0
18	7	F	OS	+4	IO REC 14	+3	IO EXT	+1
19	5	M	OS	+3	IO REC 10	+3	IO EXT	0
20	7	F	OD	+4	IO REC 14	+3	IO EXT	0
21	7	F	OS	+4	IO REC 14	+3	IO EXT	+1
22	5	F	OD	+3	IO REC 10	+3	IO EXT	0
23	5	F	OS	+3	IO REC 10	+3	IO EXT	+1
24	6	F	OD	+4	IO REC 14	+3	IO EXT	0
25	6	F	OS	+4	IO REC 14	+3	IO EXT	0
26	7	F	OD	+3	IO REC 10	+2	IO RE-REC^‡‡14	0
27	9	F	OD	+3	IO REC 10	+2	IO RE-REC 14	+1
28	4	F	OD	+3	IO REC 10	+2	IO RE-REC 14	0
29	4	M	OD	+4	IO REC 10	+2	IO RE-REC 14	0
30	8	M	OS	+2	IO REC 8	+2	IO RE-REC 14	0
31	6	M	OS	+3	IO REC 10	+2	IO RE-REC 14	0
32	9	F	OS	+2	IO REC 10	+2	IO RE-REC 14	0
33	9	M	OS	+2	IO REC 8	+2	IO RE-REC 14	+2

^* IOOA=Inferior oblique overaction

^† OP=Operation

^‡ F=Female

^§ M=Male

^∏ OD: Right eye

^# OS=Left eye

^** REC=Recession

^†† EXT=Extirpation

^‡‡ RE-REC=Re-recession

^§§ After 2nd surgery, pupil dilatation occurred.

Table 2.

Final success rate of extirpation of the inferior oblique muscle and re-recession of the inferior oblique muscle

Type of surgery Nu	umber of surgery	y Satisfactory result^†(%)
IO^* extirpation	25	24 (96.0^‡)
IO re-recession	8	7 (87.5^‡)
Total	33	31 (93.9)

^* IO=Inferior oblique muscle

^† Satisfactory result: Inferior oblique overaction of 0 or +1;

^‡ There are no statistically significant differences between the type of reoperation with P=0.38 by chi-square test.

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