SURGICAL APPROACHES TO INFERIOR OBLIQUE MUSCLE OVERACTION IN ATYPICAL STRABISMUS: A LITERATURE REVIEW

Inferior oblique muscle overaction (IOOA) is one of the most frequent motility disorders associated with atypical strabismus, particularly in V-pattern deviations. This condition significantly affects ocular alignment, binocular vision, and quality of life, while also complicating surgical planning and influencing postoperative stability. Several surgical approaches have been developed to correct IOOA and are currently performed by strabismus surgeons. The aim of this article is to summarize the modern surgical techniques used in the management of IOOA based on a literature review. Recent publications, reports, guidelines, and textbooks were analyzed. According to the review, weakening procedures-including recession, myectomy, myotomy, and anterior transposition-are the most widely employed surgical methods. Each technique has its own advantages and limitations, and evidence suggests that surgical success depends on the severity of IOOA, the type of atypical strabismus, and the individual anatomy of the patient. Moreover, combined surgical approaches are increasingly utilized to improve both functional and cosmetic outcomes. In conclusion, although surgical management of IOOA in atypical strabismus is effective, it remains a complex challenge. An individualized approach tailored to each patient is essential for achieving optimal results. Future long-term follow-up studies will play a crucial role in establishing standardized surgical guidelines for IOOA correction.