[Binocular vision and vertical strabismus]

Recession Vs Myotomy-Comparative Analysis of Two Surgical Procedures of Weakening Inferior Oblique Muscle Overaction

Introduction:

Inferior oblique overaction (IOOA) can be primary or secondary, isolated or combined to other types of horizontal deviation, mostly with esotropias. Surgical weakening of IOOA means several techniques like; recession, myotomy, myectomy, anteroposition etc.

Goals:

we analyzed the effect of inferior oblique muscle surgical weakening comparing two groups of patients with primary hypertropia.

Material and methods:

In 5-years retrospective study, we observed 33 patients on which we did the surgical procedure of weakening inferior muscle overaction by two methods; recession and myotomy.

Results:

In total number of 33 patients, there were 57,6% male and 42,4% female patients with average age of 10,6±7,5 (in range of 4–36). There was 33,3% of isolated primary hypertropias, and 66,7% combined with esotropias. At 23 (69,9%) patients the recession surgical procedure was done, and with 10 (30,1%) myotomy. Better effect and binocularity was in 65,2% of patients in recession group which was statistically significant with significance level of p<0,0, χ2=5,705; p=0,021.

Conclusion:

Comparing of two surgical procedures of weakening inferior oblique muscles overaction, recession is better procedure than myotomy.

Alphabet patterns

<zakljucak> Alfabetski sindromi predstavljaju inkomitentne strabizme ciji se horizontalni ugao razrokosti menja pri pogledu nagore, pravo i nadole. Svaki peti bolesnik sa strabizmom ima neki oblik A ili V fenomena. Ispitanici se zale na astenopijske smetnje i na duple slike, narocito pri radu nablizu i imaju prinudni polozaj glave. Kako ne postoji nijedan etioloski faktor odgovoran za pojavu ovih sindroma, veoma je vazno precizno uraditi klinicki pregled da bi se donela odluka o pravilnom lecenju. Hirurgija je neophodna metoda lecenja bolesnik sa inkomitencijom vecom od 15 DP. Neophodno je da ove operacije obavi iskusan hirurg, jer se klasicnim hirurskim indikacijama dobijaju hiperkorigovani uglovi devijacije, sto se veoma tesko podnosi, zbog pojave duple slike.