Myectomy of the inferior oblique; report on 100 cases.

THE beginnings of inferior oblique muscle weakening operations date back to the middle of the 18th century. A self-styled oculist, John Taylor, was then traversing Europe with a cure for squint which consisted of a single operation by incision in the lower angle of the eye, probably tenotomy of the inferior oblique. Then follows a description of the procedure by Bonnet (1841), but the operation was advocated as a treatment for myopia only. The history proper starts with Landolt (1885), when the possibilities of the operation as it is used nowadays were outlined. As Fink (1951) rightly remarks, there is no evidence that Landolt ever performed the operation, but it nevertheless was performed during the second half of the 19th century for torticollis arising from vertical imbalance. The weight of the opinion of von Graefe (1898), however, that obliques should not be touched in any circumstances, put a strong brake on development in this direction. The increasing confidence in the feasibility of inferior oblique surgery dates from Duane's experience with it which began in 1906-the work was never published, but it was reported in 1907 (Posey, 1915), and was referred to by White (1933). Myectomy at origin was the only procedure practised until White and Brown (1939) described tenotomy at the insertion. White (1943) described the first two cases in which recession was performed. Since then numerous papers on inferior oblique surgery have appeared, especially in the American journals; as a rule these papers condemn tenotomies and claim the advantages of the recession. Of British authors, Lyle (1953) and Nutt (1955) have for several years given evidence of the feasibility of this and other surgery of the vertical muscles.