A paired comparison study on refractive changes after Inferior oblique weakening surgery

BackgroundWe aimed to evaluate the effect of unilateral inferior oblique weakening surgery on refractive parameters by comparing the operated eye with the fellow eye of the same patient.MethodsData of patients who underwent unilateral inferior oblique muscle weakening surgery at our strabismus unit were retrospectively analyzed. Demographic data and refractive values ​​of the patients before and at 6 months postoperatively were recorded. The non-operated eyes were designed as the control group. Cylindrical axes were converted into J0 and J45 vector components. Changes in astigmatism axis were evaluated to assess torsional effects. Clinically significant refractive change was defined as a change ≥ ± 0.75 D in spherical, cylindrical, or spherical equivalent (SE) values.ResultsA total of 44 patients were included. A significant postoperative myopic shift was observed in both spherical and SE values in the operated eyes. Similar changes were noted in the control eyes. The rates of clinically significant refractive change were comparable between operated and control eyes. No statistically significant differences were found between the two groups in terms of changes in spherical, cylindrical, SE, J0, or J45 values. However, vector analysis revealed a clinically insignificant trend toward with-the-rule astigmatic change in operated eyes. There was no significant relationship between eye laterality, gender, or age and changes in SE, J0, or J45.ConclusionInferior oblique weakening surgery does not lead to significant changes in refractive values but may result in minimal shifts in astigmatic axis.