Myotomy and myectomy of the inferior oblique muscle have fallen into ill repute as technically inferior and less successful operations than recession of the muscle at its insertion; however, there is a simple, effective procedure which deserves more attention. Tenotomy of the inferior oblique muscle at its scleral insertion, which I have used successfully and to the exclusion of other procedures designed to reduce overactivity of this muscle, is the procedure of choice at the Mayo Clinic. It is my purpose not to condemn other procedures but to describe, stress, and reemphasize the value of this one.
History of Operations on the Inferior Oblique Muscle
Although Landolt1 is credited with outlining the possibility of operating on the inferior oblique muscle, there is no evidence that he actually operated on it. Dunnington2 thoroughly reviewed procedures used up to 1929 and named specific indications for tenotomy of the inferior oblique
DYER JA. Tenotomy of the Inferior Oblique Muscle at Its Scleral InsertionAn Easy and Effective Procedure. Arch Ophthalmol. 1962;68(2):176-181. doi:10.1001/archopht.1962.00960030180007