J Korean Ophthalmol Soc.  2016 Aug;57(8):1268-1273. 10.3341/jkos.2016.57.8.1268.

Changes in Ocular Excyclotorsion According to Graded Inferior Oblique Recession

• Lee D
• Kim WJ
• Kim MM

• KMID: 2349074
• DOI: http://doi.org/10.3341/jkos.2016.57.8.1268

Abstract

PURPOSE
To investigate changes in ocular excyclotorsion in patients with inferior oblique overaction (IOOA) according to amount of correction by graded inferior oblique recession and to compare the amount of excyclotorsion between primary IOOA and secondary IOOA.
METHODS
This study included 54 eyes of 54 patients who were diagnosed with unilateral IOOA and underwent graded inferior oblique recession. Fundus photographs were taken pre- and postoperatively. The sum of angles of torsion of both eyes was used to analyze changes in excyclotorsion. The angle of excyclotorsion was analyzed using the ImageJ program.
RESULTS
Eighteen eyes were grade 2, 24 eyes were grade 3 and 12 eyes were grade 4. Preoperative angle of excyclotorsion was 16.23 ± 5.96° for the patients with grade 2 eyes, 18.83 ± 5.76° for the patients with grade 3 eyes and 29.00 ± 10.23° for the patients with grade 4 eyes. Therefore, as the degree of IOOA increased, the amount of excyclotorsion became larger. There was no statistical significance between grade 2 and grade 3 (p = 0.467), however, there was a statistically significant difference between grade 3 and grade 4 (p < 0.001). Postoperative angle of excyclotorsion was significantly decreased in each group (grade 2: p = 0.020, grade 3: p < 0.001, grade 4: p = 0.041). The amount of surgical recession of inferior oblique muscle showed a positive correlation with a decrease in the angle of excyclotorsion, but was not statistically significant. The amount of excyclotorsion and the decrease of excyclotorsion after surgery were larger in secondary IOOA than in primary IOOA, but were not statistically significant (p = 0.260).
CONCLUSIONS
As the preoperative degree of IOOA increased, the amount of correction of excyclotorsion became larger but there is no statistical significance. Correction of IOOA and excylclotorsion is expected after graded inferior oblique recession.

Keyword

Excyclotorsion; Graded inferior oblique recession; Inferior oblique overaction

MeSH Terms

Humans

Figure

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  Figure 1. The angle of excyclotorsion measured using ImageJ program. The angle significantly decreased after graded inferior oblique recession. (A) Preoperative measurement. (B) Postoperative measurement.

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  Figure 2. Comparison of amount of preoperative excyclotorsion according to inferior oblique overaction grade using ANOVA test. Values are presented as mean ± SD.

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