title: Outcome of surgery for congenital fibrosis of the inferior rectus muscle.
abstract: OBJECTIVE
  To report clinical findings and surgical outcome in a large series of patients with fibrosis of the inferior rectus muscle.
  
  
  METHODS
  Subject Cases: A total of 17 cases were diagnosed with unilateral fibrosis of the inferior rectus muscle during the past 27 years at our institution. They were aged from 5 months to 17 years, with 15 cases under 10 years of age. No differences were present regarding the laterality or gender.
  
  
  RESULTS
  All the cases showed hypotropia with restricted eye elevation. Forced duction test showed resistance to upward eye movement. A horizontal deviation in primary eye position was also present in 10 cases (59%). The affected eye was amblyopic in the majority of cases. Binocular vision was absent in 15 of the 17 cases.
  
  
  RESULTS
  Surgical Outcome: All the cases received either recession or free tenotomy of the inferior rectus muscle. Resection of the ipsilateral superior rectus muscle was additionally performed to correct residual hypotropia. Fibrosis of the inferior rectus was present as intraoperative finding in all the 17 cases. Hypotropia disappeared in 10 cases and decreased in 7 cases. Restoration of satisfactory binocular alignment was obtained in all the 17 cases.
  
  
  CONCLUSIONS
  Recession of the inferior rectus muscle was effective treatment for fibrosis of the inferior rectus. Additional resection of the ipsilateral superior rectus muscle was useful to correct residual hypotropia. Free tenotomy is not recommended.
authors.affiliation: Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Maruo
authors.forename: N
authors.initials: N
authors.lastname: Kubota
authors.forename: T
authors.initials: T
authors.lastname: Sakaue
authors.forename: Y
authors.initials: Y
authors.lastname: Nemoto
authors.forename: T
authors.initials: T
authors.lastname: Hayashi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005355:Fibrosis / Q000151:congenital / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D009801:Oculomotor Muscles / Q000473:pathology* / Q000601:surgery*; D013285:Strabismus / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D015348:Vision, Binocular; D014792:Visual Acuity