Application of the Inferior Oblique Muscle Belly Transposition in V-Pattern Exotropia
Mingyu Si, Xinxiang Shao, Keshun Fan
Department of Ophthalmology of Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University, Xuzhou No.1 People's Hospital, the Affiliated Hospital of China University of Mining and Technology, Xuzhou 221001, China
Abstract： Objective: To investigate the effect of the application of the inferior oblique muscle belly transposition (IOBT) in V-pattern strabismus with mild-to-moderate inferior oblique overaction (IOOA). Methods: This was a prospective study. From January 2018 to April 2020, 40 patients (80 eyes) with V-pattern exotropia with minimal-to-moderate IOOA who underwent IOBT or inferior oblique myectomy (IOMYE) in Xuzhou No.1 People's Hospital were randomly divided into two groups: An IOBT group (n=20) and an IOMYE group (n=20). In addition to horizontal strabismus correction, the patients underwent IOBT in the IOBT group and inferior oblique myectomy (IOMYE) in the IOMYE group. There was a 6-month follow-up period. Horizontal deviation (HD), V pattern, foveal disc angle (FDA) and inferior oblique action (IOA) were analyzed before and after the operation. Data were analyzed using paired t test and independent t test. Results: Seventeen (85%) patients were cured in the IOBT group and 14(70%) in the IOMYE group. There was no significant difference (t=1.313, P=0.205) in FDA before and after surgery in the IOBT group. The differences in changes in FDA, IOA and V pattern between the two groups were statistically significant (t=-11.788, P<0.001; t=-3.701, P=0.001; t=-8.519, P<0.001). Postoperatively, the IOBT group achieved satisfactory results, without overcorrection to an A pattern. In the IOMYE group, 6 patients were overcorrected to A pattern and 8 patients had mild underaction of the inferior oblique. Conclusions: IOBT can successfully treat the V pattern in patients with mild- to-moderate IOOA. It is a supplement to traditional inferior oblique muscle weakening.
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