Assessment of Objective Cyclotorsion Changes Following Symmetric and Asymmetric Graded Recession of Inferior Oblique Muscle for V-Pattern Strabismus.

This study aimed to evaluate cyclotorsion changes after graded IO recession and compare effects of symmetric vs asymmetric surgeries on torsional asymmetry. A retrospective analysis was conducted on 50 patients (100 eyes, mean age 10.5 years) with V-pattern strabismus who underwent graded IO recession. Cyclotorsion was measured using fundus photos and Cyclocheck software before and three months after the surgery. Mean V-pattern deviation decreased significantly (18.62Δ to 2.26Δ, p<0.001). Cyclotorsion improved from 13.48° to 5.99° in right eyes and 11.50° to 8.39° in left eyes, averaging a 2.52° reduction per 2 mm of recession. A moderate positive correlation was found between total IO recession and torsion change (r=0.46). Preoperative cyclotorsion asymmetry between eyes also decreased significantly, regardless of surgical symmetry. Graded IO recession effectively reduces V-pattern deviation and excyclotorsion. It also improves interocular torsion symmetry, whether performed symmetrically or asymmetrically.