Abstract

P 020

Dose-response in inferior oblique muscle recession

Metten M., Lagrèze W. A., Staubach F.
Department of Ophthalmology, Freiburg

Objective: To determine the dose-response of inferior oblique muscle recession and to analyse the effect of an additional anteroposition (AP) as well as the differences between short term effects (SE) and long-term effects (LE).
Methods: In this retrospective study 37 patients with a median age of 29 years were selected from a 2.690 patient cohort. Inclusion criteria were: Recession of the inferior oblique muscle, unilateral inferior oblique overaction, normal retinal correspondence and pre- and postoperative examinations at the tangent screen. Exclusion criteria were: Previous ocular muscle surgery and ocular or orbital disease. 19 patients received an additional AP. Patients were examined on a tangent screen pre-operatively and one day post-operatively (SE). 16 patients underwent an additional examination 3 months post-operatively (LE). Vertical and torsional deviations, measured in different positions of gaze, were used to calculate dose-response relation by linear regression analysis.
Results: The SE without / with AP was for vertical deviation in adduction 1,2° / 1,1° per mm, in primary gaze 0,6° / 0,5° per mm and in abduction 0,3° / 0,3° per mm. The LE without / with AP was in adduction 1,4° / 1,3° per mm, in primary gaze 0,6° / 0,6° per mm and in abduction 0,4° / 0,4 ° per mm. The SE without / with AP was for rotational deviation in primary gaze 0,8° / 0,5° per mm, the LE without / with AP 0,6° / 0,1° per mm. The SE without / with AP was for V-Inkomitanz 0,5° / 0,3° per mm and the LE 0,5° / 0,2° per mm. Variance was high, for example for the vertical SE in adduction without AP 2,5° SD.
Conclusions: The dose-response of this study may be useful for surgery planning. However, one has to keep in mind the large variation of the effects.

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