Novel Inferior Oblique Muscle Y Splitting Procedure to Minimize the Anti-Elevation Syndrome: A Pilot Study
Amar Pujari, Sujeeth Modaboyina, Rajeswari Thangavel, Monika Yadav, Swati Phuljhele, Rohit Saxena Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, IndiaCorrespondence: Amar Pujari, Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-08-01
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| Series: | Clinical Ophthalmology |
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| Online Access: | https://www.dovepress.com/novel-inferior-oblique-muscle-y-splitting-procedure-to-minimize-the-an-peer-reviewed-fulltext-article-OPTH |
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| author | Pujari A Modaboyina S Thangavel R Yadav M Phuljhele S Saxena R |
| author_facet | Pujari A Modaboyina S Thangavel R Yadav M Phuljhele S Saxena R |
| author_sort | Pujari A |
| collection | DOAJ |
| description | Amar Pujari, Sujeeth Modaboyina, Rajeswari Thangavel, Monika Yadav, Swati Phuljhele, Rohit Saxena Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, IndiaCorrespondence: Amar Pujari, Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Room No. 212, RPC-1, AIIMS, New Delhi, India, Email dramarpujari@gmail.comPurpose: To describe novel Y splitting procedure of inferior oblique muscle to mitigate the anti-elevation syndrome.Methods: A pilot, prospective interventional study was undertaken to assess the effect of inferior oblique muscle Y-splitting in patients with unilateral 3+ or more overaction. To correct primary gaze hypertropia and the excyclotorsion, a Y-splitting procedure was performed (along with routine horizontal muscle surgery as per the deviation) in 14 subjects. The effect of surgery was assessed at baseline and at 6 months post-intervention.Results: The mean age of 14 subjects was 25.14± 7.70 years. The mean pre-operative hypertropia, excyclotorsion and inferior oblique muscle over-action was 18.42± 3.50 PD, 14.14± 2.65 degrees, and +3.21± 0.42 respectively. Following surgery, this was reduced to 1.57± 1.74 PD of residual hypertropia (a net correction of 16.85± 2.31 PD, p = 0.005), 3.85± 1.46 degrees of residual excyclotorsion (a net correction of 10.28± 1.72 degrees, p < 0.05), and +0.28± 0.46 of residual inferior oblique over-action (a net correction ∼+3) at the end of 6 months. Amongst fourteen patients, three patients still experienced residual/variable anti-elevation effect, and during the study period none of them experienced any adverse event and none of them required any additional surgeries.Conclusion: While anteriorizing the inferior oblique muscle to correct primary gaze hypertropia and the excyclotorsion, a novel “Y splitting” procedure can be followed to achieve the desired results with mitigated anti-elevation effect.Keywords: inferior oblique muscle surgery, anti-elevation syndrome, Y-splitting of the inferior oblique |
| first_indexed | 2024-04-11T22:27:30Z |
| format | Article |
| id | doaj.art-8069a81aff654925ba5151d55cd92361 |
| institution | Directory Open Access Journal |
| issn | 1177-5483 |
| language | English |
| last_indexed | 2024-04-11T22:27:30Z |
| publishDate | 2022-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Ophthalmology |
| spelling | doaj.art-8069a81aff654925ba5151d55cd923612022-12-22T03:59:37ZengDove Medical PressClinical Ophthalmology1177-54832022-08-01Volume 162723273177536Novel Inferior Oblique Muscle Y Splitting Procedure to Minimize the Anti-Elevation Syndrome: A Pilot StudyPujari AModaboyina SThangavel RYadav MPhuljhele SSaxena RAmar Pujari, Sujeeth Modaboyina, Rajeswari Thangavel, Monika Yadav, Swati Phuljhele, Rohit Saxena Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, IndiaCorrespondence: Amar Pujari, Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Room No. 212, RPC-1, AIIMS, New Delhi, India, Email dramarpujari@gmail.comPurpose: To describe novel Y splitting procedure of inferior oblique muscle to mitigate the anti-elevation syndrome.Methods: A pilot, prospective interventional study was undertaken to assess the effect of inferior oblique muscle Y-splitting in patients with unilateral 3+ or more overaction. To correct primary gaze hypertropia and the excyclotorsion, a Y-splitting procedure was performed (along with routine horizontal muscle surgery as per the deviation) in 14 subjects. The effect of surgery was assessed at baseline and at 6 months post-intervention.Results: The mean age of 14 subjects was 25.14± 7.70 years. The mean pre-operative hypertropia, excyclotorsion and inferior oblique muscle over-action was 18.42± 3.50 PD, 14.14± 2.65 degrees, and +3.21± 0.42 respectively. Following surgery, this was reduced to 1.57± 1.74 PD of residual hypertropia (a net correction of 16.85± 2.31 PD, p = 0.005), 3.85± 1.46 degrees of residual excyclotorsion (a net correction of 10.28± 1.72 degrees, p < 0.05), and +0.28± 0.46 of residual inferior oblique over-action (a net correction ∼+3) at the end of 6 months. Amongst fourteen patients, three patients still experienced residual/variable anti-elevation effect, and during the study period none of them experienced any adverse event and none of them required any additional surgeries.Conclusion: While anteriorizing the inferior oblique muscle to correct primary gaze hypertropia and the excyclotorsion, a novel “Y splitting” procedure can be followed to achieve the desired results with mitigated anti-elevation effect.Keywords: inferior oblique muscle surgery, anti-elevation syndrome, Y-splitting of the inferior obliquehttps://www.dovepress.com/novel-inferior-oblique-muscle-y-splitting-procedure-to-minimize-the-an-peer-reviewed-fulltext-article-OPTHinferior oblique muscle surgeryanti-elevation syndromey-splitting of the inferior oblique. |
| spellingShingle | Pujari A Modaboyina S Thangavel R Yadav M Phuljhele S Saxena R Novel Inferior Oblique Muscle Y Splitting Procedure to Minimize the Anti-Elevation Syndrome: A Pilot Study Clinical Ophthalmology inferior oblique muscle surgery anti-elevation syndrome y-splitting of the inferior oblique. |
| title | Novel Inferior Oblique Muscle Y Splitting Procedure to Minimize the Anti-Elevation Syndrome: A Pilot Study |
| title_full | Novel Inferior Oblique Muscle Y Splitting Procedure to Minimize the Anti-Elevation Syndrome: A Pilot Study |
| title_fullStr | Novel Inferior Oblique Muscle Y Splitting Procedure to Minimize the Anti-Elevation Syndrome: A Pilot Study |
| title_full_unstemmed | Novel Inferior Oblique Muscle Y Splitting Procedure to Minimize the Anti-Elevation Syndrome: A Pilot Study |
| title_short | Novel Inferior Oblique Muscle Y Splitting Procedure to Minimize the Anti-Elevation Syndrome: A Pilot Study |
| title_sort | novel inferior oblique muscle y splitting procedure to minimize the anti elevation syndrome a pilot study |
| topic | inferior oblique muscle surgery anti-elevation syndrome y-splitting of the inferior oblique. |
| url | https://www.dovepress.com/novel-inferior-oblique-muscle-y-splitting-procedure-to-minimize-the-an-peer-reviewed-fulltext-article-OPTH |
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