Evaluation of graded recession of inferior oblique muscle for correction of different grades of V-pattern strabismus
Abstract Background V pattern identification is essential for proper strabismus management. Graded recession is a tailored approach to treat inferior oblique overaction (IOOA). The aim is to evaluate the efficacy of graded recession of inferior oblique muscle for correction of different grades of V...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | BMC Ophthalmology |
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| Online Access: | https://doi.org/10.1186/s12886-023-03210-x |
| _version_ | 1827723935860391936 |
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| author | Shaimaa Hady Sokeer Ahmed L. Ali El-Sayed S. Arafa Amr M. Awara Heba M. Shafik |
| author_facet | Shaimaa Hady Sokeer Ahmed L. Ali El-Sayed S. Arafa Amr M. Awara Heba M. Shafik |
| author_sort | Shaimaa Hady Sokeer |
| collection | DOAJ |
| description | Abstract Background V pattern identification is essential for proper strabismus management. Graded recession is a tailored approach to treat inferior oblique overaction (IOOA). The aim is to evaluate the efficacy of graded recession of inferior oblique muscle for correction of different grades of V pattern. Methods Forty patients from 3 to 18 years old with V pattern strabismus and primary IOOA were evaluated by prism cover test to assess the grade of IOOA and amplitude of V-pattern. Graded recession of IO muscle depends on the amplitude of the V-pattern and degree of IOOA. Eight mm recession for amplitude 15 PD to 20 PD and mild IOOA (10 PD-15 PD or + 1) ,10 mm recession for amplitude 20–30 PD and moderate IOOA (15–25 PD or + 2) and maximum recession for amplitude more than 30 PD and marked IOOA (≥ 25 PD or + 3). Simultaneous correction of the horizontal deviation was performed. Follow up after I week,1 month ,3 month and 6-month. Trial Registration Number (TRN) (NCT05786053) on 23/3/2023. Results The mean age of the study patients was 9 ± 4.261. Twenty patients (50%) had V-pattern esotropia, 12 (30%) exotropia, 4 (10%) orthotropic and four (10%) had Dissociated vertical deviation (DVD). Four cases 10% were of grade 1, 20 cases (50%) grade 2 and 16 cases (40%) were of grade 3. Of eighty eyes, 66 eyes (82.5%) were fully corrected with no residual IOOA, and 14 eyes (17.5%) were under corrected. V-pattern was corrected in 28 cases 70% and only 12cases (30%) had residual V-pattern grade 1. Conclusions Graded recession is an effective procedure for correction of V pattern strabismus with various grades of primary inferior oblique overaction. It can be tailored according to the the degree of IO overaction which is significantly related to the grade of V pattern. The 8 mm recession for IO was significantly related to recurrence or inadequate break of the V pattern in our studied cases. The grade of IOOA correlates with the amplitude of V-pattern. The amount of recession was planned according to preoperative IOOA and grade of V-pattern with frequent undercorrections obtained by the standard 8 mm recession. A + 2 overaction merits a 10-mm recession of the inferior oblique. A + 3 or + 4 overaction merits a 14-mm maximal recession. |
| first_indexed | 2024-03-10T22:07:49Z |
| format | Article |
| id | doaj.art-d2a1e08ea6994802ad6e74c12a08a488 |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-03-10T22:07:49Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-d2a1e08ea6994802ad6e74c12a08a4882023-11-19T12:45:29ZengBMCBMC Ophthalmology1471-24152023-11-012311810.1186/s12886-023-03210-xEvaluation of graded recession of inferior oblique muscle for correction of different grades of V-pattern strabismusShaimaa Hady Sokeer0Ahmed L. Ali1El-Sayed S. Arafa2Amr M. Awara3Heba M. Shafik4Department of Ophthalmology, Faculty of Medicine, Tanta UniversityDepartment of Ophthalmology, Faculty of Medicine, Tanta UniversityDepartment of Ophthalmology, Faculty of Medicine, Tanta UniversityDepartment of Ophthalmology, Faculty of Medicine, Tanta UniversityDepartment of Ophthalmology, Faculty of Medicine, Tanta UniversityAbstract Background V pattern identification is essential for proper strabismus management. Graded recession is a tailored approach to treat inferior oblique overaction (IOOA). The aim is to evaluate the efficacy of graded recession of inferior oblique muscle for correction of different grades of V pattern. Methods Forty patients from 3 to 18 years old with V pattern strabismus and primary IOOA were evaluated by prism cover test to assess the grade of IOOA and amplitude of V-pattern. Graded recession of IO muscle depends on the amplitude of the V-pattern and degree of IOOA. Eight mm recession for amplitude 15 PD to 20 PD and mild IOOA (10 PD-15 PD or + 1) ,10 mm recession for amplitude 20–30 PD and moderate IOOA (15–25 PD or + 2) and maximum recession for amplitude more than 30 PD and marked IOOA (≥ 25 PD or + 3). Simultaneous correction of the horizontal deviation was performed. Follow up after I week,1 month ,3 month and 6-month. Trial Registration Number (TRN) (NCT05786053) on 23/3/2023. Results The mean age of the study patients was 9 ± 4.261. Twenty patients (50%) had V-pattern esotropia, 12 (30%) exotropia, 4 (10%) orthotropic and four (10%) had Dissociated vertical deviation (DVD). Four cases 10% were of grade 1, 20 cases (50%) grade 2 and 16 cases (40%) were of grade 3. Of eighty eyes, 66 eyes (82.5%) were fully corrected with no residual IOOA, and 14 eyes (17.5%) were under corrected. V-pattern was corrected in 28 cases 70% and only 12cases (30%) had residual V-pattern grade 1. Conclusions Graded recession is an effective procedure for correction of V pattern strabismus with various grades of primary inferior oblique overaction. It can be tailored according to the the degree of IO overaction which is significantly related to the grade of V pattern. The 8 mm recession for IO was significantly related to recurrence or inadequate break of the V pattern in our studied cases. The grade of IOOA correlates with the amplitude of V-pattern. The amount of recession was planned according to preoperative IOOA and grade of V-pattern with frequent undercorrections obtained by the standard 8 mm recession. A + 2 overaction merits a 10-mm recession of the inferior oblique. A + 3 or + 4 overaction merits a 14-mm maximal recession.https://doi.org/10.1186/s12886-023-03210-xV pattern strabismusInferior oblique overactionGraded recessionDissociated vertical deviation |
| spellingShingle | Shaimaa Hady Sokeer Ahmed L. Ali El-Sayed S. Arafa Amr M. Awara Heba M. Shafik Evaluation of graded recession of inferior oblique muscle for correction of different grades of V-pattern strabismus BMC Ophthalmology V pattern strabismus Inferior oblique overaction Graded recession Dissociated vertical deviation |
| title | Evaluation of graded recession of inferior oblique muscle for correction of different grades of V-pattern strabismus |
| title_full | Evaluation of graded recession of inferior oblique muscle for correction of different grades of V-pattern strabismus |
| title_fullStr | Evaluation of graded recession of inferior oblique muscle for correction of different grades of V-pattern strabismus |
| title_full_unstemmed | Evaluation of graded recession of inferior oblique muscle for correction of different grades of V-pattern strabismus |
| title_short | Evaluation of graded recession of inferior oblique muscle for correction of different grades of V-pattern strabismus |
| title_sort | evaluation of graded recession of inferior oblique muscle for correction of different grades of v pattern strabismus |
| topic | V pattern strabismus Inferior oblique overaction Graded recession Dissociated vertical deviation |
| url | https://doi.org/10.1186/s12886-023-03210-x |
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