Comparison of Different Surgical Approaches to Inferior Oblique Overaction

J Binocul Vis Ocul Motil. Jul-Sep 2020;70(3):89-93. doi: 10.1080/2576117X.2020.1776566. Epub 2020 Jun 8.


Background: The purpose of this study is to compare surgical outcomes of recession, anteriorization, and myotomy for the treatment of inferior oblique overaction (IOOA).

Methods: A retrospective chart review of all patients undergoing IOOA correction from July 2010 to March 2017 at the Children's Hospital of Colorado was performed. Preoperative grading of IOOA (+0.5 to +4.0) was compared to post-operative IOOA (0 to +4.0). The goal was reduction of IOOA to 0, but any decrease in IOOA was measured.

Results: There were a total of 260 patients with 357 eyes. Gender and age were similar across surgery types. A 94.6% of eyes had a decrease in IOOA with recession (n = 165) of the inferior oblique while 86.1% decreased to no IOOA. Anteriorization of the inferior oblique (n = 115) decreased overaction in 97.4% of eyes with 81.7% improving to zero degree of IOOA. Myotomy of the inferior oblique (n = 77) was found to decrease overaction in 98.7% of eyes and reduce IOOA to zero in 88.3%. There was no significant difference among type of surgery and outcome.

Conclusion: All three surgical interventions were found to be equally successful in reducing the amount of IOOA.

Keywords: Strabismus surgery; inferior oblique overaction; strabismus.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Eye Movements / physiology
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Myotomy
  • Oculomotor Muscles / physiopathology
  • Oculomotor Muscles / surgery*
  • Ophthalmologic Surgical Procedures*
  • Postoperative Period
  • Retrospective Studies
  • Strabismus / physiopathology
  • Strabismus / surgery*
  • Treatment Outcome
  • Vision, Binocular / physiology