J Korean Ophthalmol Soc > Volume 57(8); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(8):1268-1273.
DOI: https://doi.org/10.3341/jkos.2016.57.8.1268    Published online August 15, 2016.
Changes in Ocular Excyclotorsion According to Graded Inferior Oblique Recession.
Donghun Lee, Won Jae Kim, Myung Mi Kim
Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea. mmk@med.yu.ac.kr
단계적 하사근후전술에 따른 수술 후 안구 외회선의 변화
이동훈⋅김원제⋅김명미
영남대학교 의과대학 안과학교실
Correspondence:  Myung Mi Kim,
Email: mmk@med.yu.ac.kr
Received: 3 March 2016   • Revised: 21 April 2016   • Accepted: 27 May 2016
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.
Key Words: Excyclotorsion;Graded inferior oblique recession;Inferior oblique overaction


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