Purpose: This study aimed to evaluate the changes in macular thickness following inferior oblique muscle recession surgery. Materials and Methods: Thirty-eight eyes from 21 patients undergoing ocular muscle surgery were included. Patients were grouped into three groups based on the type of surgical intervention: Group I (n = 12), inferior oblique recession surgery alone; Group II (n = 12), inferior oblique plus horizontal muscle surgery; Group III (n = 14), horizontal muscle surgery alone. Each eye was scanned using the optical coherence tomography (OCT) device preoperatively and on the first postoperative day to measure macular thickness. Results: Following surgery, a significant increase in foveal thickness occurred in Group I (P < 0.05) and Group II (P < 0.01). In addition, a statistically significant difference was observed between the groups with regard to the increase in foveal thickness (P = 0.016), with significantly lower changes in Group III. Conclusion: Our findings suggested that inferior oblique muscle recession surgery is associated with an increase in macular thickness.