Myectomy of the inferior oblique muscle.

The current surgical procedures usually selected to weaken clinically overactive inferior oblique muscles are recession, disinsertion, or myectomy. A review of published reports revealed that each technique appeared to produce the intended result but that investigators differed in their choices for reasons of simplicity, quickness, and complications. Our experience indicated distal myectomy to be simple, quick, predictable, and devoid of significant complications. To affirm our impressions, 130 myectomies performed in 81 patients were reviewed. The procedure was satisfactory, although 5% had a postoperative residual overaction, and 3% had a residual underaction. No significant complications, such as the "adherence syndrome," were observed.