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  • Title: [Triple partial myotomy of the inferior oblique muscle. Comparison with retropositioning and free myectomy].
    Author: Krásný J, Kubistová V.
    Journal: Cesk Oftalmol; 1992 May; 48(3):191-8. PubMed ID: 1525893.
    Abstract:
    In a twelve-year investigation the authors compare the results of three types of weakening operations of the inferior oblique muscle in 298 eyes. The evaluation lead to their views regarding indications of different surgical techniques. In their opinion the best operation is triple partial myotomy of the inferior oblique muscle as it does not influence the horizontal position and preserves the original insertion of the muscle. They modify the techniques of Romer-Apis and Martinez-Oropeza. Fixation of the inferior and external rectus on hooks reveals the surgical field, and the concurrent stretching of the inferior oblique muscle beneath the conjunctiva facilitates its dissection. The authors include triple partial myotomy except for hypertropias in the comprehensive surgical procedure together with plication of the ipsilateral superior oblique muscle in paresis of the trochlear nerve. They indicate retroposition of the inferior oblique muscle only in divergence associated with hyperfunction of the inferior oblique muscle. The operation has a favourable effect on convergent synkinesis and enhances convergence by +2 to +5 degrees. The authors consider free myectomy of the inferior oblique muscle the least physiological operation and use it no longer.
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