Transposition Of Inferior Oblique Muscle Research Articles

Evaluation of anterior transposition of inferior oblique muscle for correction of V- pattern associated with DVD and inferior oblique overaction

Evaluation of anterior transposition of inferior oblique muscle for correction of V- pattern associated with DVD and inferior oblique overaction

Simultaneous Superior Rectus Recession and Anterior Transposition of Inferior Oblique Muscle as a Surgical Option for Traumatically Lost Inferior Rectus Muscle

ABSTRACTPurpose: To evaluate the role of simultaneous superior rectus (SR) recession and anterior transposition of inferior oblique (ATIO) muscle in patients with traumatically lost inferior rectus (IR) muscle.Methods: Six patients with history of ocular trauma, followed by sudden onset vertical diplopia along with marked hypertropia (HT) and limitation of depression in abduction in the affected eye suggestive of IR disinsertion, were included in this prospective study. The patients were treated by simultaneous SR recession and ATIO muscle in the affected eye by limbal conjunctival approach under local anesthesia.Results: Preoperatively, primary position HT of 40–50 (mean 44.16 ± 4.91) prism diopters (PD) was present in all cases which increased to 65–70 (mean 65.83 ± 5.84) PD in down and in the ipsilateral gaze along with marked limitation of depression in abduction and A pattern. On exploration, the IR could not be traced in four cases. Fibrotic muscle sheath with retracted IR was found 10–12 mm away from the limbus in rest of the two patients. ATIO (6.5 mm from the limbus) with simultaneous recession of ipsilateral SR was done under local anesthesia.At 12 weeks postoperatively, three patients were orthophoric in primary position and vertical alignment with in 4–7 PD in primary position was achieved in rest of the three patients.Conclusion: Simultaneous SR recession with ATIO seems to be a good alternative to achieve satisfactory vertical alignment for patients with traumatically lost inferior rectus muscle.

The Effect of Inferior Oblique Muscle Transposition in Primary and Secondary Inferior Oblique Muscle Overaction

Purpose: To evaluate and compare the effect of transposition of inferior oblique muscle in patients with primary inferior oblique muscle overaction and secondary due to superior oblique muscle palsy. Methods: The present study included 41 patients (53 eyes), who appeared to have primary or secondary inferior oblique muscle overaction due to superior oblique muscle palsy and received transposition of inferior oblique muscle with at least 3 months of follow-up. Patients were retrospectively analyzed to compare the effect of correction and its prognosis. Inferior oblique muscle overaction was graded as +1 to +4 according to the severity. Successful surgery was defined as postoperative inferior oblique muscle overaction from 0 to +1 and failure as above +2. Hypertropia in primary gaze was also recorded to evaluate the effect of correction. Results: Twenty-six (35 eyes) and 15 (18 eyes) patients with primary and secondary inferior oblique muscle overaction due to superior oblique muscle palsy, respectively, received transposition of inferior oblique muscle. Patients with primary inferior oblique muscle overaction showed correction of 2.1 ± 0.9 with preoperative inferior oblique muscle overaction of 2.0 ± 0.7. Patients with secondary inferior oblique muscle overaction showed a correction of 2.3 ± 0.9 with preoperative value of 2.3 ± 0.8. Each 3.2 ± 4.1 prism diopters (PD) and 6.5 ± 5.3 PD of hypertropia at primary gaze showed correction of 3.0 ± 7.4 PD and 6.3 ± 5.1 PD, respectively, in each group. Conclusions: Primary and secondary inferior oblique muscle overaction due to superior oblique muscle palsy showed no difference in correction of overaction and hypertropia after transposition of inferior oblique muscle. Except for presence of inferior oblique muscle underaction, the correction appears effective with good prognosis. J Korean Ophthalmol Soc 2015;56(9):1424-1431

Surgical management of long-standing antielevation syndrome after unilateral anterior transposition of the inferior oblique muscle

To investigate surgical management of patients with long-standing antielevation syndrome following unilateral anterior transposition of inferior oblique muscle. We present a series of 3 consecutive patients with significant hypotropia several years after unilateral anterior transposition surgery. An approach combining denervation-extirpation of the inferior oblique muscle and subsequent inferior rectus muscle recession and contralateral superior rectus muscle recession was used to manage all 3 patients. Denervation-extirpation surgery alone or with ipsilateral inferior rectus muscle recession were not enough to improve vertical misalignment in these patients. All 3 patients achieved successful results after denervation-extirpation surgery, ipsilateral inferior rectus muscle recession, and contralateral superior rectus muscle recession. In this case series, devervation-extirpation surgery on the inferior oblique muscle, ipsilateral inferior rectus recession, and contralateral superior rectus recession improved vertical misalignment in patients with long-standing antielevation syndrome after unilateral anterior transposition of the inferior oblique.

Unilateral Recession-Resection Surgery with Inferior Displacement Combined with Augmented Anterior Transposition of Inferior Oblique Muscle

We report the effects of unilateral recession-resection surgery of the horizontal recti muscles with inferior displacement and augmented anterior transposition of the inferior oblique muscle with a posterior intermuscular suture in a patient with large exotropia and considerable hypertropia.

Anterior transposition of inferior oblique muscle for treatment of unilateral superior oblique muscle palsy with inferior oblique muscle overaction.

Although many weakening procedures for the inferior oblique muscle have been advocated, there is some controversy as to the most beneficial procedure for weakening overacting inferior oblique muscles. This study was undertaken to determine if unilateral anterior transposition of the inferior oblique muscle alone could be a safe and effective procedure for treating unilateral superior oblique palsy from the perspective of hypertropia, inferior oblique overaction, and abnormal head posture. The records of 33 patients, who underwent anterior transposition of the inferior oblique muscle for unilateral superior oblique palsy at our institution between Jan 1995 and Dec 2002, were retrospectively reviewed. The average preoperative inferior oblique overaction was 2.3 +/- 0.64, and the hypertropia in the primary position was 12.3 +/- 7.69 prism diopter (PD). Twenty-six patients showed head tilt to the opposite direction preoperatively. After the anterior transposition of the inferior oblique, inferior oblique overaction was diminished in 32 patients (97%). Twenty-six out of 33 patients (79%) had no hypertropia in the primary position at last postoperative assessment. Of the 26 patients with head tilt before surgery, 21 patients (81%) achieved full correction after surgery. Satisfactory results were obtained in most of the patients in our study with the exception of three patients who required additional surgery. No patient demonstrated postoperative hypotropia in the primary position. None of the patients noticed elevation deficiency or lower lid elevation. The anterior transposition of the inferior oblique was found to be safe and effective for treating superior oblique palsy with secondary overaction of the inferior oblique muscle.