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

• Lee D
• Kim WJ
• Kim MM

• KMID: 2505987
• DOI: http://doi.org/10.3341/kjo.2019.0139

Abstract

Purpose
To evaluate the changes in esodeviation after inferior oblique (IO) recession in patients with refractive accommoda- tive esotropia and IO overaction.
Methods
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.
Results
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).
Conclusions
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.

Keyword

Esotropia; Strabismus; Surgery