J Korean Ophthalmol Soc > Volume 52(9); 2011 > Article
Journal of the Korean Ophthalmological Society 2011;52(9):1128-1134.
DOI: https://doi.org/10.3341/jkos.2011.52.9.1128    Published online September 15, 2011.
Secondary Superior Oblique Overaction after Inferior Oblique Muscle Myectomy in a Patient Misdiagnosed with Inferior Oblique Muscle Overaction.
Hyun Kyung Kim, Young Choon Lee
1Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, St. Vincent's Hospital, Suwon, Korea.
2Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea. yclee@cmcnu.or.kr
하사근기능항진으로 오인하여 하사근 절제술 후 발생한 이차 상사근기능항진
김현경1⋅이영춘2
Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, St. Vincent’s Hospital1, Suwon, Uijeongbu St. Mary’s Hospital2, Uijeongbu, Korea
Abstract
PURPOSE
To report a case of superior oblique muscle tenotomy in a patient with suspected bilateral inferior oblique muscle overaction. The patient showed secondary superior oblique muscle overaction and inferior oblique muscle underaction after inferior oblique muscle myectomy. CASE SUMMARY: The patient showed V-pattern exotropia with suspected bilateral inferior oblique muscle overaction. After bilateral lateral rectus muscle recession with bilateral inferior oblique muscle myectomy, the patient showed secondary esotropia and inferior oblique underaction. After the surgery, progressive secondary superior oblique muscle overaction continued and finally, a superior oblique muscle tenotomy was performed. After the superior oblique muscle tenotomy, the superior oblique muscle overaction was corrected but the inferior oblique muscle underaction continued. CONCLUSIONS: After an inferior oblique muscle myectomy, secondary superior oblique muscle overaction can develop. Thus, caution should be taken in diagnosing inferior oblique muscle overaction in patients who show minimally inferior oblique muscle overaction as well as the surgical methods chosen.
Key Words: Consecutive esotropia;Inferior oblique muscle overaction;Secondary Inferior oblique muscle underaction;Secondary superior oblique muscle overaction;V-pattern exotropia


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