Detecti̇on of macular changes by opti̇cal coherence tomography after i̇nferi̇or obli̇que muscle surgery

Purpose: To evaluate the success of the surgical procedure and detect macular changes by the use of optical coherence tomograpy in patient who underwent surgery of inferior oblique muscle disinsertion + distal muscle resection + tucking prosedure. Materials and Methods: 27 eyes of 20 patients who underwent surgery of inferior oblique muscle disinsertion + distal muscles resection + tucking procedure between January 2012 to June 2013, in the department of ophthalmology of Akdeniz University Faculty of Medicine were included in the study. Preoperative and postoperative values of visual acuity, refraction measurement, anterior segment and dilated fundus examination and the examination of strabismus of all cases were compared. The success rate of the procedure and complications were analyzed. In all cases, OCT examination was performed preoperatively and also postoperative second day, first week, first month, 3 months later and 6 months later and these results were evaluated. esults: 27 eyes of 20 cases,14 males (70%) and 6 women (30%), were examined. Mean follow-up period was 13.75 ± 5.6 months (6-24 months). The mean age was 10.65 ± 5.9 years (range 5-27 years). There was no change in preoperative and postoperative refraction measurements. Also there was no change in visual acuity after the operation. 11 (55%) cases had primary inferior oblique muscle overaction and 9 (45%) cases had secondary inferior oblique muscle overaction. The mean preoperative degree of hyperfunction was +3.7. Postoperatively, there was no hyperfunction in 21 eyes, but +1 hyperfunction in 5 eyes and +2 inferior oblique muscle overaction in 1 eye was observed. Success rate of operation was 77.8%. No complications were observed during or after the operation. There were no statistically significant differences in macular thickness analysis in optic koherence tomography postoperatively. Conclusions: In this study, success rate of the various surgical techniques performed in cases with inferior oblique muscle overaction and postoperative complications were evaluated. The purpose of this study was highlighting the advantages and disadvantages of the technique, thus to enable comparative studies. Altough more studies are needed to assess long-term results, we have concluded that the inferior oblique muscle disinsertion + distal muscle resection and tucking process is a safe, simple and effective procedure which doesn't cause any morphological damage of the macula in patients with inferior oblique muscle overaction Keywords: Inferior oblique muscle overaction, disinsertion, distal muscle resection, optical coherence tomography, macular thickness analysis.