Tucking the inferior oblique muscle into Tenon's capsule following myectomy

Abstract

Purpose: Myectomy of the inferior oblique muscle is a common procedure used to correct overaction of this muscle. Previous descriptions of the surgery have not discussed how the surgeon should handle the proximal muscle stump following myectomy. This study examined the effectiveness of inferior oblique muscle myectomy with tucking of the muscle into Tenon's capsule for treatment of inferior oblique muscle overaction.

Methods: The procedure was studied prospectively in 22 patients who underwent 32 inferior oblique muscle myectomies. In 18 patients, the intraoperative behavior of the inferior oblique muscle was recorded. Complete ocular motility examinations were performed before and after surgery. Success was defined as the elimination of inferior oblique muscle overaction and the elimination of hypertropia secondary to persistent ipsilateral inferior oblique muscle overaction in primary gaze.

Results: The surgery corrected inferior oblique muscle overaction in 94% of eyes. Hypertropia secondary to persistent ipsilateral inferior oblique muscle overaction was eliminated in 92% of patients. There was no correlation between outcome and the intraoperative behavior of the inferior oblique muscle.

Conclusion: Tucking of the inferior oblique muscle stump into Tenon's capsule is recommended following inferior oblique myectomy. This procedure is safe and effective for correcting inferior oblique muscle overaction.