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목적 : To determine whether recurrent or consecutive horizontal deviation is a valid indication for surgery for dissociated vertical deviation (DVD) associated with inferior oblique overaction (IOOA) and to evaluate the effects of bilateral inferior oblique transposition (BIOT) on horizontal deviation in primary position.
방법 : Retrospective chart review was conducted in 19 patients who had DVD and IOOA with consecutive or recurrent horizontal deviation and underwent modified bilateral inferior oblique muscle transposition (BIOT) surgery. Patients were divided into 3 subgroups: patients who underwent only BIOT (BIOT group, n=9), BIOT with medial rectus (MR) recession or lateral retus (LR) resection simultaneously (ET BIOT group, n=6) and BIOT with LR recession or MR resection simultaneously (XT BIOT group, n=4). Postoperative angle of horizontal deviation and corrected amount of horizontal deviation at over 6 months
결과 : The mean age of patients was 55.11 ± 21.05 months (32 to 115). The mean follow-up period after surgery was 8.68 ± 2.87 months (6 to 18). DVD and IOOA were markedly reduced in all patients. Preoperative horizontal deviation was 4.23 ± 5.99 PD (0 to 16) in BIOT, -17.33 ± 7.76 PD (-30 to 6) in ET BIOT and 17.50 ± 2.52 (14 to 20) PD in XT BIOT. Minus means esodeviation. The corrected amount of horizontal deviation was 3.56 ± 5.18 PD (0 to 16) with BIOT surgery alone.
결론 : Uncorrected IOOA and DVD in infantile strabismus may be disruptive to the maintenance of primary stable eye position after primary surgery. Hence, this condition was a valid surgical indication of BIO transposition. Minimal exodeviation was corrected by BIO transposition alone. In addition, larger secondary eso- or exodeviation should be corrected with proper horizontal muscle surgery along with BIO transposition.
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