Long-term Outcome of Graded Inferior Oblique Recession

ABSTRACT

PURPOSE: To evaluate the efficacy and prognosis of graded inferior oblique recession in inferior oblique overaction. METHODS: We reviewed the records of 92 patients (184 eyes) who had been diagnosed with inferior oblique overaction and who had undergone an inferior oblique recession in both eyes. All were followed up for a minimum of 1 year postoperatively, and preoperative exclusion criteria included superior oblique palsy, history of vertical rectus muscle surgery, and previously performed inferior oblique muscle surgery. Inferior oblique overaction was graded from +1 (mild overaction) to +4 (severe overaction) and each group had 6 mm, 8 mm, 10 mm, and 14 mm inferior oblique recessions performed, respectively. Cases of postoperative inferior oblique overaction under +1 were considered successful. (In the group initially graded as +1, a postoperative grade of 0 was considered a success.) On the other hand, a grade over +1 was considered a failure. RESULTS: The average postoperative follow-up time was 43.7 months (12~159 months). On final examination, 6-mm inferior oblique recession (5 eyes) resulted in 100% success, 8-mm inferior oblique recession (76 eyes) resulted in a 94.7% success rate, 10-mm inferior oblique recession (97 eyes) resulted in an 87.5% success rate, and 14-mm inferior oblique recession (6 eyes) resulted in a 50% success rate. The overall success rate was 89.7% (165 eyes of the 184 eyes). CONCLUSIONS: Graded inferior oblique recession in patients diagnosed with inferior oblique overaction was an effective procedure with stable, long-term outcomes.