ABSTRACT
Purpose: to study effectiveness of accurate evaluation and surgery of the inferior oblique muscle in cases of V-pattern strabismus with primary inferior oblique over-action
Material and Methods: Twenty eyes of ten patients with V-Pattern strabismus and primary inferior oblique over-action were examined and operated upon in Minya University Hospital, from September 2003 to April 2004. Operative technique used in this study was combined recession-resection for horizontal deviation, with transposition of the medial rectus downwards in two cases and graded recession-anteriorizaion of the inferior oblique
Results: Orthotropia in nine diagnostic positions of gaze occurred in four cases [two of them with recession-resection and MR. trans-position]. Under-correction of horizontal deviation occurred in four cases and residual inferior oblique over-action with horizontal deviation occurred in two cases
Conclusion: The effect of inferior oblique weakening procedures on horizontal alignment needs to be thoroughly studied and calculated added to the role of abnormal muscle insertion as a cause of V-pattern should be kept in mind during medial rectus muscle surgery