Korean J Ophthalmol.  2020 Aug;34(4):304-310. 10.3341/kjo.2019.0139.

Changes in Esodeviation after Inferior Oblique Recession in Patients with Refractive Accommodative Esotropia and Inferior Oblique Overaction

  • 1Department of Ophthalmology, Catholic University of Daegu, School of Medicine, Daegu, Korea
  • 2Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
  • 3Nune Eye Hospital, Daegu, Korea


To evaluate the changes in esodeviation after inferior oblique (IO) recession in patients with refractive accommoda- tive esotropia and IO overaction.
Graded IO recession was performed in 68 patients who were diagnosed with refractive accommodative esotropia with IO overaction. The patients were followed for at least 3 months after surgery and the angle of esodeviation with cor-rection was evaluated at distance and near at each follow-up evaluation. The patients were divided into two groups: patients who underwent unilateral IO recession (UIO-Rec) and patients who underwent bilateral IO recession (BIO-Rec). The change in esodeviation after surgery was compared between the two groups.
A total of 68 patients were enrolled in this study, with 38 patients in the UIO-Rec group and 30 in the BIO-Rec group. In the UIO-Rec group, there was no statistically significant difference in esodeviation before and after surgery. In the BIO-Rec group, esodeviation at distance increased significantly 1 day postoperatively (p = 0.033). However, esodeviation returned to the preoperative value one week after surgery (p = 0.665). Changes in esodeviation at distance were significantly greater in the BIO-Rec group than in the UIO-Rec group one day after surgery (p = 0.044).
Bilateral IO-weakening surgery induced a transient increase in esodeviation in patients with refractive accom-modative esotropia. However, we found no evidence that well-controlled esotropia with corrected hyperopia became de-compensated after IO-weakening surgery, as induced esodeviation was minor and temporary.


Esotropia; Strabismus; Surgery
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