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Antielevation syndrome after unilateral anteriorization of the inferior oblique muscle.

Cho YA, Kim JH, Kim S - Korean J Ophthalmol (2006)

Bottom Line: Unilateral IOAT may result in antielevation syndrome.Therefore bilateral IOAT is recommended to balance antielevation in both eyes.A meticulous caution is needed when performing unilateral IOAT.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea. earth317@yahoo.co.kr

ABSTRACT

Purpose: To report antielevation syndrome with restriction of elevation on abduction in the operated eye and overaction (OA) of the inferior oblique muscle (IO) of the contralateral eye after unilateral IO anteriorization (AT).

Methods: Medical records were reviewed retrospectively in 8 of 24 patients who underwent unilateral IOAT. Four patients were referred from other hospitals after the same surgery.

Results: Four patients had infantile esotropes. The rest showed accommodative esotropia, superior oblique palsy, exotropia, and consecutive exotropia. The mean amount of hyperdeviation was 16.3 PD (10 approximately 30). The mean restriction of elevation on abduction in the operated eye was -1.6 (-1 approximately -4) and IOOA of the contralateral eye was +2.7 (+2 approximately +3). IOAT of nonoperated eyes in 4 patients, IO weakening procedure of anteriorized eyes in 2 patients, and IO myectomy on an eye with IOAT in 1 patient were performed. Ocular motility was improved after surgery in all patients.

Conclusions: Unilateral IOAT may result in antielevation syndrome. Therefore bilateral IOAT is recommended to balance antielevation in both eyes. A meticulous caution is needed when performing unilateral IOAT.

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Related in: MedlinePlus

After 10 mm myectomy of the posterior half of the inferior oblique muscle (IO) from the original insertion and 4.5 mm recession of the superior rectus muscle in the right eye, patient No. 5 obtained normal function of the IO. However, small DVD of the left eye appeared in upgaze without spontaneous elevation.
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Figure 4: After 10 mm myectomy of the posterior half of the inferior oblique muscle (IO) from the original insertion and 4.5 mm recession of the superior rectus muscle in the right eye, patient No. 5 obtained normal function of the IO. However, small DVD of the left eye appeared in upgaze without spontaneous elevation.

Mentions: At 1 year postoperatively, IOOA of the right eye disappeared and esophoria of 10 PD was noted in the right eye (Fig. 2-2).


Antielevation syndrome after unilateral anteriorization of the inferior oblique muscle.

Cho YA, Kim JH, Kim S - Korean J Ophthalmol (2006)

After 10 mm myectomy of the posterior half of the inferior oblique muscle (IO) from the original insertion and 4.5 mm recession of the superior rectus muscle in the right eye, patient No. 5 obtained normal function of the IO. However, small DVD of the left eye appeared in upgaze without spontaneous elevation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2908826&req=5

Figure 4: After 10 mm myectomy of the posterior half of the inferior oblique muscle (IO) from the original insertion and 4.5 mm recession of the superior rectus muscle in the right eye, patient No. 5 obtained normal function of the IO. However, small DVD of the left eye appeared in upgaze without spontaneous elevation.
Mentions: At 1 year postoperatively, IOOA of the right eye disappeared and esophoria of 10 PD was noted in the right eye (Fig. 2-2).

Bottom Line: Unilateral IOAT may result in antielevation syndrome.Therefore bilateral IOAT is recommended to balance antielevation in both eyes.A meticulous caution is needed when performing unilateral IOAT.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea. earth317@yahoo.co.kr

ABSTRACT

Purpose: To report antielevation syndrome with restriction of elevation on abduction in the operated eye and overaction (OA) of the inferior oblique muscle (IO) of the contralateral eye after unilateral IO anteriorization (AT).

Methods: Medical records were reviewed retrospectively in 8 of 24 patients who underwent unilateral IOAT. Four patients were referred from other hospitals after the same surgery.

Results: Four patients had infantile esotropes. The rest showed accommodative esotropia, superior oblique palsy, exotropia, and consecutive exotropia. The mean amount of hyperdeviation was 16.3 PD (10 approximately 30). The mean restriction of elevation on abduction in the operated eye was -1.6 (-1 approximately -4) and IOOA of the contralateral eye was +2.7 (+2 approximately +3). IOAT of nonoperated eyes in 4 patients, IO weakening procedure of anteriorized eyes in 2 patients, and IO myectomy on an eye with IOAT in 1 patient were performed. Ocular motility was improved after surgery in all patients.

Conclusions: Unilateral IOAT may result in antielevation syndrome. Therefore bilateral IOAT is recommended to balance antielevation in both eyes. A meticulous caution is needed when performing unilateral IOAT.

Show MeSH
Related in: MedlinePlus