title: Self-grading effect of inferior oblique recession.
abstract: OBJECTIVE
  Inferior oblique (IO) myectomy can result in self-adjustment; the greater the preoperative hyperdeviation, the larger the postoperative correction. This study estimated the effect of IO recession in primary position and in contralateral gaze.
  
  
  METHODS
  Records of 43 patients with IO muscle overaction associated with congenital unilateral superior oblique palsy were reviewed retrospectively. Seventeen patients who had a unilateral 10-mm recession (IO attached at 2 mm temporal and 3 mm posterior from the inferior rectus muscle insertion) and 26 patients who had a standard 14-mm recession were evaluated at 3 months postoperatively. The effect of the recession was measured by preoperative hyperdeviation minus postoperative hyperdeviation.
  
  
  RESULTS
  The average preoperative hyperdeviation was 13.4 ± 4.83 prism diopters (PD) in primary position and 16.2 ± 6.32 PD in contralateral gaze in the 10-mm group and 8.0 ± 3.48 PD in primary position and 12.76 ± 4.55 PD in contralateral gaze in the 14-mm group. The average deviation at 3 months postoperatively was 2.1 ± 3.03 in primary position and 2.6 ± 3.95 PD in contralateral gaze in the 10-mm group and 0.8 ± 1.21 in primary position and 1.8 ± 1.95 PD in contralateral gaze in the 14-mm group. The range of self-adjusting effect at 3 months postoperatively was 3 to 20 PD in primary position and 5 to 30 PD in contralateral gaze in the 10-mm group and 3 to 15 PD in primary position and 4 to 24 PD in contralateral gaze in the 14-mm group. The self-grading effect was large and displayed no significant differences at 3 months postoperatively in the 10- and 14-mm groups (P = .104 and .560, respectively).
  
  
  CONCLUSIONS
  Both IO recession procedures were largely self-grading and no significant differences were evident at 3 months postoperatively.
authors.affiliation: Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Yoo
authors.forename: Seung-Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Seo
authors.forename: Hae Jung
authors.initials: HJ
authors.lastname: Paik
authors.forename: Yoonae A
authors.initials: YA
authors.lastname: Cho
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D013285:Strabismus / Q000601:surgery*; D016896:Treatment Outcome; D020432:Trochlear Nerve Diseases / Q000601:surgery*; D015348:Vision, Binocular / Q000502:physiology; D055815:Young Adult