RESULTS OF TREATMENT OF SUPERIOR OBLIQUE OVERACTION BY SILICONE TENDON-EXPANDER TECHNIQUE

Purpose: To report the results of treatment of a series of patients wi th superior oblique overaction using the superior oblique silicone ten don-expander technique. Methods: A chart review of 17 patients with su perior oblique overaction who had a total of 26 silicone tendon-expand er procedures was conducted. Results: Mean preoperative degree of supe rior oblique overaction was +2.7. 92% of eyes had mild (+1) or no resi dual overaction at last postoperative assessment (follow-up range: 6 t o 59 months). Of 15 patients with preoperative A-pattern of 10 prism d iopter (Delta) or more, only two patients (13%) had A-pattern of 10 De lta or more at last assessment. Of 13 patients with preoperative hypot ropia in primary position, five patients (38%) had no vertical deviati on in primary position, and seven patients (54%) had persistent, but l ess vertical deviation in primary position at last assessment (mean re duced from 11 Delta to 4 Delta). No patient manifested superior obliqu e palsy at their last postoperative assessment. Conclusions: We believ e that the superior oblique tendon-expander technique should be strong ly considered for the treatment of superior oblique overaction associa ted with A-pattern or hypotropia in primary position, because it has a high success rate and a low incidence of postoperative complications. Consecutive superior oblique underaction did not occur in this series .