New surgical intervention for the weakening of the inferior oblique muscle: Equatorial scleral anchor

Purpose: To evaluate the efficacy of a new surgical technique in reducing inferior oblique muscle overaction. Methods: Anterior transposition and myectomy of the inferior oblique muscle represent the gold- standard treatment in dissociated vertical deviation, including cases in which a simultaneous inferior oblique muscle overaction is also present. A new surgical procedure that consists of suturing the muscle to the sclera at the Gobin point with tendon sparing using a micro-incision to minimize the related tissue trauma and induce a faster recovery was developed. Results: Two of 8 patients with essential infant esotropia had a complete resolution of the elevation in adduction with no residual vertical imbalance. All patients experienced an improvement in lateral incomitance. Conclusions: The new "equatorial scleral anchor" surgical procedure gives a similarly good outcome when compared with the classic inferior oblique anterior transposition technique, with the advantages being simple, safe, reversible, and modular in terms of suturing.