Our preferred technique is a myectomy performed near the insertion, below the inferior border of the lateral rectus. This affords easy exposure of the inferior oblique muscle, in an area where an adequate excision of up to 8 mm of muscle may be done. Good hemostasis is obtained through cauterization of the clamped ends of the muscle. Such excision affords less opportunity for the cut ends to reunite, or to become adherent to the sclera in a new functional insertion.
Description of Technique
The conjunctival incision extends inferiorly from the inferior border of the lateral rectus muscle for approximately 5 mm. A muscle hook is placed beneath the lateral rectus muscle to identify that structure (Fig, 1), and to aid in traction and rotation of the globe. A second round muscle hook, flattened at the tip and of medium size, is placed heel-to-heel with the first muscle hook. In this
McNEER KW, SCOTT AB, JAMPOLSKY A. A Technique for Surgically Weakening the Inferior Oblique Muscle. Arch Ophthalmol. 1965;73(1):87-88. doi:10.1001/archopht.1965.00970030089019