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ORIGINAL ARTICLE
Year : 2018  |  Volume : 19  |  Issue : 1  |  Page : 72-77

Anteriorization of inferior oblique muscle in management of dissociated vertical deviation with or without inferior oblique muscle overaction


Department of Ophthalmology, Al-Azhar University, Cairo, Egypt

Correspondence Address:
Mahmoud M Saleh
Department of Ophthalmology, Al-Azhar University, Cairo 11441
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/DJO.DJO_60_17

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Purpose The aim of this study was to evaluate and compare the effect of anterior temporal transposition of the inferior oblique (IO) muscle in the management of dissociated vertical deviation (DVD) whether associated with or without inferior oblique muscle overaction (IOOA). Patients and methods This study was carried out on 34 eyes (20 patients) with DVD of at least 10 prism diopters (Δ) in the involved eye. The patients were divided into two groups. Group I included 17 eyes of 11 patients having DVD with IOOA, and group II included 17 eyes of nine patients having DVD without IOOA. The IO muscle was approached through the conjunctiva and Tenon’s capsule by an inferior-temporal fornix incision. The size of preoperative and postoperative DVD, grade of the preoperative and postoperative IOOA, repeat surgeries, and complications were recorded and evaluated. Results The average correction of DVD in group I was 8.13 Δ (preoperative 16.53 Δ and postoperative 8.5 Δ, P<0.001) and 9.47 Δ in group II (preoperative 17.67 Δ and postoperative 8.2 Δ, P<0.001). The mean IOOA was corrected from +2.0±0.5 to +0.18±0.4 in group I (P<0.001). The mean follow-up period was 9.2±2.2 months in group I and 9.3±3.1 months in group II. Conclusion Anteriorization of the IO muscle was effective in correcting DVD with or without IOOA. Preoperative DVD equal to or less than 15 Δ had favorable outcome, but DVD more than 15 Δ had less favorable outcome.


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