The authors report the results of bilateral modified inferior oblique (IO) transposition considering the equator in seven patients with infantile strabismus syndrome with inferior oblique overaction (IOOA) and dissociated vertical deviation (DVD). Mean age was 4.5 years (2-7) and mean follow-up was 6.3 months. Mean distance between the lateral border of the inferior rectus insertion and equator was 5.6mm (4.5-6.5). Nine patients had IO transposed onto the equator and five were placed 1mm anterior to the equator. Preoperatively all had IOOA of ≥1.5. Postoperatively IOOA was <1+ in all cases. Six patients had DVD within 1PD and only one patient had DVD of 5PD. No cases of anti-elevation syndrome were found postoperatively. Therefore the authors propose that good surgical results are achieved with this procedure although they acknowledge the small sample size. 

Modified inferior oblique transposition considering the equator for primary inferior oblique overaction (IOOA) associated with dissociated vertical deviation (DVD).
Yoo EJ, Kim SH.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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