Inferior Oblique muscle disinsertion-myectomy (Incomplete hooking of muscle) Procedure
In this video we demonstrate incomplete hooking of an inferior oblique muscle during disinsertion-myectomy. The right eye is being viewed from its temporal aspect. The inferior part of the globe is below and the superior part above. The lateral rectus muscle has been isolated and hooked through an inferotemporal fornix incision. Further blunt dissection is carried out in a posterior direction, inferior to lateral rectus in order to expose the muscle belly of the inferior oblique. A Graefe hook is then introduced into the subtenon’s space, and directed posteriorly along the surface of the sclera until the belly of the inferior oblique muscle is engaged. The muscle is freed of surrounding connective tissue. During inspection of the subtenon’s space it is evident that some posterior fibers of the inferior oblique belly have not been hooked. A second hook is introduced, capturing these fibers and adding them to the muscle belly isolated initially. The procedure can now be successfully completed.