ISOLATED INFERIOR OBLIQUE MYECTOMY FOR HYPERTROPIA

Authors

  • Sadia Bukhari
  • Ghulam Qadir Kazi
  • Umair Qidwai

Abstract

Background: Hypertropia is a condition in which one eye is elevated relative to the other, either intermittently or constantly. It causes significant problem either cosmetically or by abnormal head posture and thus needs to be corrected surgically. This study was conducted to evaluate the success rate and complications of isolated inferior oblique myectomy in patients with hypertropia. Methods: Patients having hypertropia (Deviation >6 prism diopters [PD]) associated with inferior oblique over-action were included in this observational Case-series, conducted from July 2011 to December 2012, at Al Ibrahim eye Hospital, Karachi. Patients underwent unilateral inferior oblique myectomy. Final outcome was considered at the end of three months at which achievement of ≤2 PD of hypertropia was considered as a success. Results: During the study period, 58 patients were included. Hypertropia was most commonly associated with exotropias 23 (39.7%) followed by esotropias in 18 (31%). Mean angle of hypertropia was reduced from 13.55±4.43 prism diopters to 0.48±1.08 prism diopters. Out of 58 patients, 55 (94.8%) had achieved success after surgery while only 3(5.2%) patients had residual hypertropia of greater than 2 prism diopters (p=0.001). No direct complications of procedure observed intra-operatively or up to 3 months post operatively but significant overcorrection of residual horizontal deviation observed after horizontal squint surgery in these eyes. Conclusion: Isolated inferior oblique myectomy is highly successful and safe surgical procedure for correction of hypertropia.Keywords: Hypertropia, Inferior oblique myectomy, outcome

References

Tollefson MM, Mohney BG, Diehl NN, Burke JP. Incidence and types of childhood hypertropia: a population-based study. Ophthalmology 2006;113:1142–5.

Speer C, Pearlman J, Phillips PH, Cooney M, Repka MX. Fourth cranial nerve palsy in pediatric patients with pseudotumor cerebri. Am J Ophthalmol 1999;127:236–7.

Robb RM, Idiopathic superior oblique palsies in children. J Pediatr Ophthalmol Strabismus 1990;27(2):66–69.

Lim HT, Jin YH.Concomitant Hypertropia with Intermittent Exotropia. J Korean Ophthalmol Soc 2001;42:459–63. (Korean)

Toosi SH, von Noorden GK. Effect of isolated inferior oblique muscle myectomy in the management of superior oblique muscle palsy. Am J Ophthalmol 1979;88(3 Pt 2):602–8.

Bahl RS, Marcotty A, Rychwalski PJ, Traboulsi EI. Comparison of inferior oblique myectomy to recession for the treatment of superior oblique palsy. Br J Ophthalmol 2013;97:184–8.

Hatz KB, Brodsky MC, Killer HE. When is isolated inferior oblique muscle surgery an appropriate treatment for superior oblique palsy? Eur J Ophthalmol 2006;16:10–6.

Downloads

Published

2014-09-01

Issue

Vol. 26 No. 2 (2014): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

License

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.