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Dose–response relationship in inferior oblique muscle recession

  • Neurophthalmology
  • Published:
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Abstract

Background

Recession of the inferior oblique muscle is a widely applied operation in the treatment of strabismus sursoadductorius. In this retrospective study, the dose–response relationship of this procedure was determined in order to improve surgical outcomes. In particular, the effect of an additional anteroposition of the operated muscle was analysed, as well as differences between short and long term results.

Methods

This retrospective study included 37 patients. Inclusion criteria were unilateral strabismus sursoadductorius and normal retinal correspondence. Exclusion criteria comprised previous ocular muscle surgery and any ocular or orbital disease. Nineteen patients had received an additional anteroposition of the muscle. Patients were examined at a tangent screen pre-operatively and 1 day post-operatively (short-term effect). Sixteen patients underwent an additional examination 3 months post-operatively (long-term effect). Changes of vertical, torsional and horizontal deviations, measured in different positions of gaze, were related to the surgical dose in order to calculate the dose–response relationship by linear regression analysis.

Results

Surgery always reduced preoperative deviations. The short-term vertical dose–response without/with anteroposition was 0.6°/0.5° per mm in primary gaze and 1.2°/1.1° per mm in adduction. The short-term torsional dose–response without/with anteroposition was 0.8°/0.5° per mm in primary gaze. Three months later, the vertical effect had remained constant, whereas the torsional effect had decreased to 0.6°/0.1° per mm. Variance was high, e.g. the standard deviation of the short-term effect for the vertical deviation in adduction was 2.5°.

Conclusions

Despite the large variation of effects, a dose–response relationship could be established, facilitating surgical planning. Large vertical deviations with small excyclodeviation are an indication for additional anteropositioning. The torsional effect of inferior oblique muscle recessions can diminish over time.

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Acknowledgement

We kindly thank S. Priglinger for performing the simulation of our surgeries with the above mentioned computer software and for helpful comments on IOM function.

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Authors and Affiliations

  1. Universitäts-Augenklinik, Killianstr 5, 79106, Freiburg, Germany

    Miriam Metten, Heike Link, Flemming Staubach, Michael Bach & Wolf A. Lagrèze

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  1. Miriam Metten
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  2. Flemming Staubach
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  4. Wolf A. Lagrèze
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Correspondence to Wolf A. Lagrèze.

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There was no sponsoring for this study. We guarantee that the manuscript will not be published elsewhere in any language without the consent of the copyright holders, that the rights of third parties will not be violated, and that the publisher will not be held legally responsible should there be any claims for compensation.

We have full control of all primary data, and we agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review our data if requested.

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Metten, M., Link, H., Staubach, F. et al. Dose–response relationship in inferior oblique muscle recession. Graefes Arch Clin Exp Ophthalmol 246, 593–598 (2008). https://doi.org/10.1007/s00417-007-0763-6

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  • DOI: https://doi.org/10.1007/s00417-007-0763-6

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