Inferior oblique muscle over action is a common disorder of ocular motility. There are two types of IOOA, primary and secondary. Several techniques are used in surgical corrections of IOOA. Different studies have investigated the superiority of these procedures, but none of them are the choice treatment for correction of IOOA.

A retrospective cross sectional study performed on patients with IOOA who underwent surgical treatment in ophthalmology department of RasulAkaram hospital, a tertiary care center in Tehran. The surgical procedures include disinsertion, myectomy and anterior transposition. The record of all patients who underwent surgical treatment for IOOA between 2001 and 2011 were reviewed and data were obtained using specified checklist. The analyses were implemented using the SPSS 19.0 software.

A total of 122 eyes of 74 patients included in this study.The surgical treatment included disinsertion which was performed on 9.8% of patients, Myectomy (74.6%) and anterior transposition (15.6%).After surgery, hypertropia was seen in 9 eyes while hypotropia increased in one patient. Post-operative esotropia and exotropia were not observed in any surgical treatment. V-pattern and DVD remained in only 10 and 8 eye respectively. The success rate in disinsertion, Myectomy and Anterior transposition groups were 91.7%, 97.8% and 89.5% respectively and these measures did not change up to last visit.

We conclude that all these three procedures are effective in the treatment of either primary or secondary IOOA in pediatrics and adults and minimum side effects have seen in these procedures.