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Resection and Transposition of the Inferior Oblique for Hypertropia due to the Inferior Rectus Loss
하직근 손실로 인한 70프리즘디옵터 상사시의 치료로 하사근절제술을 동반한 전치술
JKOS 2019 Aug;60(8):816-9
Published online August 15, 2019;
Copyright © 2019 The Korean Ophthalmological Society.
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Ji Min Kwon, MD, Soo Jung Lee, MD, PhD
권지민 · 이수정

Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
인제대학교 의과대학 해운대백병원 안과학교실
Received January 3, 2019; Revised March 3, 2019; Accepted July 18, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: To report a case of resection and transposition of the inferior oblique muscle combined with superior rectus recession as treatment for large-angle hypertropia due to unilateral loss of the inferior rectus muscle.
Case summary: A 39-year-old man presented with a complaint of left hypertropia and vertical diplopia caused by blunt trauma 20 years previously. Left hypertropia of 70 prism diopters (PD) and exotropia of 16 PD in the primary gaze were noted; ocular movements of the left eye showed overactive supraduction (+4) and underactive infraduction (-5). On surgical exploration, neither the inferior rectus muscle nor capsule were present at the insertion site. The patient was diagnosed with loss of the inferior rectus muscle, thus, 7 mm of the inferior oblique muscle was resected and transposed at the original insertion site of the inferior rectus muscle; the superior rectus muscle was then recessed by 4.5 mm. After the surgery, vertical alignment was straight in the primary position, infraduction limitation was changed from -5 preoperative to -2 postoperative, and supraduction was changed from +4 preoperative to -2 postoperative.
Conclusions: Extensive resection and transposition of the inferior oblique muscle combined with recession of the superior rectus may help in obtaining a successful surgical outcome in patients with inferior rectus muscle loss with a large angle of vertical deviation.
Keywords : Hypertropia, Inferior oblique muscle, Transposition, Trauma


December 2019, 60 (12)