What to expect from primary inferior oblique overaction after esotropia surgery
Abstract Background Overelevation in adduction is common in patients with primary esotropia. This study evaluates the variation in ocular motility pattern in patients with primary inferior oblique (IO) muscle overaction after esotropia surgery. Methods The medical records of consecutive patients who...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Ophthalmology |
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| Online Access: | https://doi.org/10.1186/s12886-023-03256-x |
| _version_ | 1827581759409094656 |
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| author | Paulo Freitas-da-Costa Hélio Alves Renato Santos-Silva Fernando Falcão-Reis Jorge Breda Augusto Magalhães |
| author_facet | Paulo Freitas-da-Costa Hélio Alves Renato Santos-Silva Fernando Falcão-Reis Jorge Breda Augusto Magalhães |
| author_sort | Paulo Freitas-da-Costa |
| collection | DOAJ |
| description | Abstract Background Overelevation in adduction is common in patients with primary esotropia. This study evaluates the variation in ocular motility pattern in patients with primary inferior oblique (IO) muscle overaction after esotropia surgery. Methods The medical records of consecutive patients who underwent surgery for infantile, partially accommodative, and basic esotropia over eleven years and had at least one year of follow-up were reviewed. Patients with primary inferior oblique muscle overaction (IOOA) presented at baseline or during follow-up were selected and divided according to the first surgery performed concurrently with horizontal rectus surgery: without IO recession (NO-recess), with unilateral IO recession (UNIL-recess), and with bilateral IO recession (BIL-recess). The success (version normalisation or at least 2 points upgrade in severity scale [0–4] in the operated eye), recurrence rates, and the evolution of the non-operated IO muscles were evaluated. Results One hundred and ten patients were included – 53 NO-recess, 26 UNIL-recess, and 31 BIL-recess. Medial rectus muscle posterior fixation sutures surgery (PFS) was performed in 88.2% of patients for esotropia. A recession with graded anterior transposition was the weakening IO procedure. In the NO-recess group, 28 (52.8%) patients normalised their mild IOOA after PFS surgery alone. In the UNI-recess group, the success rate was 88.5%, with 16 (61.5%) patients showing worsened IO muscle of the fellow eye, which prompted additional surgery in 10 patients. In the BIL-recess group, all 31 patients improved the adduction pattern of the operated eye for an 80.6% success rate (6 improved marginally). Conclusion Graded anterior transposition of the inferior oblique muscle effectively normalises versions. However, it’s frequent for a contralateral overaction to become manifest after unilateral IO surgery. |
| first_indexed | 2024-03-08T22:40:00Z |
| format | Article |
| id | doaj.art-025bb513ad4c43608ff46322f0690583 |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-03-08T22:40:00Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-025bb513ad4c43608ff46322f06905832023-12-17T12:10:35ZengBMCBMC Ophthalmology1471-24152023-12-012311610.1186/s12886-023-03256-xWhat to expect from primary inferior oblique overaction after esotropia surgeryPaulo Freitas-da-Costa0Hélio Alves1Renato Santos-Silva2Fernando Falcão-Reis3Jorge Breda4Augusto Magalhães5Department of Ophthalmology, São João University Hospital CenterAnatomy Unit, Department of Biomedicine, Faculty of Medicine, University of PortoDepartment of Ophthalmology, São João University Hospital CenterDepartment of Ophthalmology, São João University Hospital CenterDepartment of Ophthalmology, São João University Hospital CenterDepartment of Ophthalmology, São João University Hospital CenterAbstract Background Overelevation in adduction is common in patients with primary esotropia. This study evaluates the variation in ocular motility pattern in patients with primary inferior oblique (IO) muscle overaction after esotropia surgery. Methods The medical records of consecutive patients who underwent surgery for infantile, partially accommodative, and basic esotropia over eleven years and had at least one year of follow-up were reviewed. Patients with primary inferior oblique muscle overaction (IOOA) presented at baseline or during follow-up were selected and divided according to the first surgery performed concurrently with horizontal rectus surgery: without IO recession (NO-recess), with unilateral IO recession (UNIL-recess), and with bilateral IO recession (BIL-recess). The success (version normalisation or at least 2 points upgrade in severity scale [0–4] in the operated eye), recurrence rates, and the evolution of the non-operated IO muscles were evaluated. Results One hundred and ten patients were included – 53 NO-recess, 26 UNIL-recess, and 31 BIL-recess. Medial rectus muscle posterior fixation sutures surgery (PFS) was performed in 88.2% of patients for esotropia. A recession with graded anterior transposition was the weakening IO procedure. In the NO-recess group, 28 (52.8%) patients normalised their mild IOOA after PFS surgery alone. In the UNI-recess group, the success rate was 88.5%, with 16 (61.5%) patients showing worsened IO muscle of the fellow eye, which prompted additional surgery in 10 patients. In the BIL-recess group, all 31 patients improved the adduction pattern of the operated eye for an 80.6% success rate (6 improved marginally). Conclusion Graded anterior transposition of the inferior oblique muscle effectively normalises versions. However, it’s frequent for a contralateral overaction to become manifest after unilateral IO surgery.https://doi.org/10.1186/s12886-023-03256-xEsotropiaStrabismusOcular motility disorderInferior oblique muscleEye movements |
| spellingShingle | Paulo Freitas-da-Costa Hélio Alves Renato Santos-Silva Fernando Falcão-Reis Jorge Breda Augusto Magalhães What to expect from primary inferior oblique overaction after esotropia surgery BMC Ophthalmology Esotropia Strabismus Ocular motility disorder Inferior oblique muscle Eye movements |
| title | What to expect from primary inferior oblique overaction after esotropia surgery |
| title_full | What to expect from primary inferior oblique overaction after esotropia surgery |
| title_fullStr | What to expect from primary inferior oblique overaction after esotropia surgery |
| title_full_unstemmed | What to expect from primary inferior oblique overaction after esotropia surgery |
| title_short | What to expect from primary inferior oblique overaction after esotropia surgery |
| title_sort | what to expect from primary inferior oblique overaction after esotropia surgery |
| topic | Esotropia Strabismus Ocular motility disorder Inferior oblique muscle Eye movements |
| url | https://doi.org/10.1186/s12886-023-03256-x |
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