Aa. Seawright et Ga. Gole, RESULTS OF TREATMENT OF SUPERIOR OBLIQUE OVERACTION BY SILICONE TENDON-EXPANDER TECHNIQUE, Journal of pediatric ophthalmology and strabismus, 35(1), 1998, pp. 33-37
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
.