Bilateral anterior transposition of the inferior obliques
J. L. Mims 3rd and R. C. Wood
Department of Ophthalmology, University of Texas Health Science Center, San Antonio.
Sixty-one children with bilateral overaction of the inferior oblique muscle
with concurrent or previous infantile esotropia received bilateral inferior
oblique recessions with anteriorization to a point 2 to 4 mm anterior to
the lateral end of the inferior rectus insertion. Subsequent reoperation
for recurrent overaction of the inferior obliques was needed in only one
case. Also, substantial reduction in dissociated vertical deviation (DVD),
when present, and almost complete absence of subsequent need for surgery
for DVD among the 61 children of this series were new findings. Only one of
the 61 required subsequent surgery for manifest DVD. In another series of
60 infantile esotropes of similar ages drawn from the same practice who had
previously had no inferior oblique surgery, nine needed surgery for DVD.
This difference (one of 61 vs nine of 60) was significant.
