title: Recession and measured, graded anterior transposition of the inferior oblique muscles for V-pattern strabismus: outcome of 44 procedures in 22 typical patients.
abstract: OBJECTIVE
  This study aimed to evaluate the efficacy of recession and graded anterior transposition of the inferior oblique (IO) muscle to correct or to reduce V-pattern strabismus and associated IO overaction.
  
  
  METHODS
  The technique used was that proposed by Wright, using the temporal border and the insertion of the inferior rectus as the reference points to locate the new insertion. In a retrospective study, 51 patient histories were analyzed and from this group, 22 patients were selected as most typical examples. Patients with hypertropias greater than 6 prism diopters (PD), a dissociated vertical deviation (DVD) greater than 8 PD or decompensated DVD were excluded.
  
  
  RESULTS
  A total of 44 eye surgeries on 22 patients were analyzed. We observed favorable results ("statistically significant") concerning the reduction of the IO overaction or V incomitance. In 45.5% (20 eyes) the IO function was normalized, in 15.9% (7 eyes) there was a reduction to -1 (underaction) and in 34.1% (15 eyes) there was a reduction, but there still remained a +1 overaction. In 77.3% of the patients there was a "satisfactory" outcome of the V pattern, defined as a residual incomitance less than 10 PD.
  
  
  CONCLUSIONS
  In this group of patients with V-pattern strabismus and IO overaction, the recession and measured, graded anterior transposition based on Wright's technique showed satisfactory results ("statistically significant") in correcting the V incomitance and normalizing or reducing the IO overaction.
authors.affiliation: Department of Ophthalmology, Hospital das Clinicas, University of São Paulo, 01417-010 São Paulo, Brazil.
authors.forename: Mariza
authors.initials: M
authors.lastname: Polati
authors.forename: Cintia
authors.initials: C
authors.lastname: Gomi
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005133:Eye Movements; D005260:Female; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000637:transplantation*; D012189:Retrospective Studies; D013285:Strabismus / Q000601:surgery*; D016896:Treatment Outcome; D015348:Vision, Binocular