Fifty patients who only had bilateral inferior oblique weakening procedures were retrospectively analyzed to determine the third month postoperative horizontal alignment change produced in the primary position. No significant horizontal change occurred in 84% of the patients and, in those who manifested a change, it was never greater than 8Δ. Six percent manifested an esophoria shift of more than 3Δ and 10% had an exophoria shift of more than 3Δ. It was concluded that the surgeon should not fear producing a postoperative esotropia by weakening the inferior oblique muscles in patients who preoperatively have straight eyes in the primary position.
Stager DR, Parks MM. Inferior Oblique Weakening ProceduresEffect on Primary Position Horizontal Alignment. Arch Ophthalmol. 1973;90(1):15-16. doi:10.1001/archopht.1973.01000050017003