Session: Poster session B

The results of anterior transposition of the inferior oblique: anterior fibres sutured to sclera versus anterior and posterior fibers separately sutured to sclera technique

Luminita Anamaria TEODORESCU¹

¹OFTALMIX SOP, Ophthalmology Clinic Bucharest, Bucuresti, Romania

Purpose: To evaluate the results of two techniques of inferior oblique anterior transposition (IOAT) in patients with DVD.

Methods and results: 193 patients, age between 6 months and 30 years, follow-up 19-225 months.

Group 1: 122 patients, mean follow 63, 4 up months.

Only the anterior fibers of the inferior oblique (IO) were placed at the temporal corner of the inferior rectus (IR) insertion. The mean DVD reduction was 7, 36 PD. 15/122 patients (18, 3%) developed antielevation syndrome (AES) in 19-70 months after surgery.

Group 2: 61 patients, 36 with esotropia, 12 patients with exotropia, mean follow-up 23, 07 months. The anterior and posterior fibers were separately sutured to sclera, posterior fibers 3 mm posterior. 7/47 patients developed AES in 10-51 months after surgery.

Group 2 A: IO was sutured at the IR insertion: 24 patients, esotropia, DVD, inferior oblique overaction (IOOA), mean reduction 7, 4 PD, but 5 patients developed AHS in 18 - 51 months after surgery.

Group 2 B: 2 mm posterior the IR insertion: 25 patients, esotropia, DVD and IOOA, mean reduction 5,6 PD, only 2 patients developed AHS after 21 months.

Group 2 C: 8 patients, esotropia, DVD, no IOOA, mean reduction 2, 5 PD, one AES.

Group 2 D: 4 patients, exotropia, DVD, IOOA mean reduction 4, 75 PD

Group 3: 10 patients with esotropia, asymmetrical DVD or IOOA, mean follow up 8,50 months, treated by asymmetrical IOAT; mean DVD reduction was 7,60 PD, no AES.

DVD reduction in group 1 is close to group 2A, but more cases developed AES in group 1. AES developed especially in cases with difference in IOOA or difference ≥ 6 PD in DVD magnitude.

NO AES developed in group 3.

Conclusions: IOAT with anterior and posterior fibers of the IO separate sutured to sclera 2 mm posterior the IR insertion is a safe and effective procedure for DVD correction ≤ 15 PD, with low risk of AES. In patients with difference in IOOA or DVD magnitude, asymmetrical IOAT should be used in order to avoid AES.