Evaluation of Inferior Oblique Muscle Overaction Existence Time and Surgical Outcomes in Infantile Esotropia

Purpose: Evaluation of inferior oblique muscle overaction (IOOA) existence time and surgical outcomes in infantile esotropia. Material and Method: A total of 100 patients who underwent operation for infantile esotropia (IE) were included in the study. Full ophthalmic assessment, including ocular motility, best-corrected visual acuity, cycloplegic refraction, any of alternant prism cover test or Hirschberg/Krimsky test, was performed. Results: Forty-nine patients (49%) were male and (51%) were female. The mean age at IE diagnosis was 23.2±18.6 months. The mean follow-up time was 43.7±18.0 months. The mean horizontal deviation - corrected and uncorrected - was 36.75±10.45 PD and 40.05±8.39 PD, respectively. We found that there was no statistically significant relationship between existence time of IOOA and the age at IE diagnosis (p: 0.486, p: 0.251). IOOA was detected in 69 patients. Inferior oblique (IO) muscle weakening procedures were performed in 45 of 69 patients. In 45 patients who had undergone surgery for IOOA, 24 (53.3%) had bilateral IO recession, 10 (22.2%) had bilateral IO tenotomy, 8 (17.7%) had unilateral IO tenotomy, 1(2.2%) had unilateral myectomy, 1 (2.2%) had bilateral myectomy, and 1 (2.2%) had bilateral anteroposition. IOOA degrees after IO recession and tenotomy surgery were found to be significantly lower than the preoperative values (p=0.0586, p=0.7258). Discussion: There was no statistically significant relationship between the existence time of IOOA and the age of IE diagnosis. We concluded that IO tenotomy and IO recession surgical techniques are effective and safe procedures for cases which have IOOA associated with IE. (Turk J Ophthalmol 2013; 43: 419-23)