Simultaneous Superior Oblique Tenotomy and Inferior Oblique Recession in Brown's Syndrome

Parks, Marshall M.; Eustis, H. Sprague

doi:10.1016/s0161-6420(87)33347-0

Cited by 49 publications

(14 citation statements)

References 7 publications

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“…However, overaction of the inferior oblique muscle (IOOA) frequently occurs following a tenotomy or tenectomy of SO. in 1987, Parks and Eustis7 proposed a combined procedure of SO tenotomy with simultaneous IO recession. In 1991, Wright8 reported the effectiveness of a procedure involving insertion of a silicone expander.…”

mentioning

confidence: 99%

Surgical Outcomes in Correction of Brown Syndrome

Cho

Kim

Graef³

2006

Korean J Ophthalmol

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PurposeTo evaluate the outcomes of surgery for Brown syndrome.MethodsWe reviewed the charts of 15 patients who underwent surgery for Brown syndrome. The limitation of elevation in adduction (LEA) ranged from -2 to -4 degrees. A superior oblique muscle (SO) tenotomy was performed in 4 patients, a silicone expander was inserted in the SO of 9 patients, and a SO recession was performed in 2 patients. The results of surgery were analyzed with a follow-up period of more than 6 months, 42.3±48.42 months on average.ResultsNine female patients and 6 male patients with unilateral Brown syndrome were selected for this study. The left eye was the affected eye in 9 patients. The degree of preoperative LEA was -2 to -4 in 4 patients in whom SO tenotomy was performed, -3 to -4 in 9 patients treated with the silicone expander, and -2 to -4 in 2 patients treated with SO recession. The LEA was released after surgery in all patients without postoperative adhesion. However, unilateral overaction of the inferior oblique muscle due to excessive weakening of the SO occurred in 1 patient with tenotomy (25%) and in 1 patient with insertion of a silicone expander (11%).ConclusionsLEA was released after tenotomy, insertion of a silicone expander and recession of the SO in 13 of 15 patients with Brown syndrome. SO palsy due to overcorrection and under-correction with postoperative adhesion should be avoided.

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mentioning

confidence: 99%

Surgical Outcomes in Correction of Brown Syndrome

Cho

Kim

Graef³

2006

Korean J Ophthalmol

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“…16 A combined procedure, including superior oblique tenotomy and inferior oblique recession, has been successful in decreasing the rate of induced superior oblique palsy. 3 Following this combination procedure, however, 75% of operated eyes revealed inferior oblique underaction in the early postoperative period. There was significant undercorrection as late as 10 to 24 months after surgery, but there was a trend for improvement with long-term follow-up.…”

Section: Discussionmentioning

confidence: 97%

“…Superior oblique tenotomy is one of the most popular procedures, its major advantage being that the operation is technically simple and fast compared with other superior oblique weakening procedures; the drawback of this technique is the possibility of iatrogenic superior oblique palsy with overcorrection, which may be irreversible. [3][4][5][6][7] In the superior oblique silicone expander procedure, the cut ends of the superior oblique tendon are separated by a silicone band. This approach slackens the superior oblique tendon in a graded and reversible fashion without altering the superior oblique insertion.…”

mentioning

confidence: 99%

Superior oblique tendon spacer with application of nonabsorbable adjustable suture for treatment of Brown syndrome

Yazdian

Kamali-Alamdari

Yazdian

et al. 2008

Journal of American Association for Pediatric Ophthalmology and

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“…[13][14][15] Superior oblique tenotomy is frequently associated with both undercorrection and superior oblique palsy.13 15 The incidence of palsy can be reduced by ipsilateral inferior oblique recession but this may further reduced elevation in adduction.15 When the silicone expander technique is used, inferior oblique weakening is unnecessary. The good and stable cosmetic result achieved by the use of a silicone expander is matched by reports in the literature.13…”

Section: Discussionmentioning

confidence: 99%