Effect of 10-mm superior oblique posterior tenectomy combined with frenulum dissection in A-pattern with superior oblique overaction.

Full Abstract

PURPOSE: To evaluate the effect of 10-mm tenectomy of the posterior fibers of the superior oblique (SO) tendon combined with dissection of the frenulum for correction of A-pattern deviation and vertical deviation with SO overaction. DESIGN: Retrospective, interventional case series. METHODS: Seventy-five patients with A-pattern strabismus associated with SO overaction who underwent surgery between March 1, 2004 and August 31, 2007. Retrospective analysis of A-pattern strabismus patients with SO overaction who underwent unilateral or bilateral 10-mm SO posterior tenectomy combined with frenulum dissection and who underwent at least 12 months of follow-up. RESULTS: The mean preoperative amount of A-pattern for all patients was 21.20 +/- 7.25 prism diopters (PD), with a mean postoperative collapse of 17.63 +/- 5.33 PD (range, 10 to 30 PD), which was statistically significant (P = .001). After surgery, the mean A-pattern correction was 22.12 +/- 6.30 PD in the group that underwent bilateral posterior tenectomy and 13.33 +/- 5.20 PD in the group that underwent unilateral posterior tenectomy. The mean degree of preoperative vertical deviation in the group that underwent unilateral posterior tenectomy was 11.50 +/- 3.96 PD, and the mean correction was 9.21 +/- 4.22 PD (P = .01). There were no surgical complications, except in 5 patients, who manifested mild inferior oblique overaction. CONCLUSIONS: We believe that 10-mm SO posterior tenectomy combined with frenulum dissection effectively collapses A-pattern deviation of less than 25 PD with mild to moderate SO overaction and reduces associated vertical deviation of 10 PD.

Author information

Author/s: Heo, Hwan (H); Lee, Kwang Hoon (KH); Ahn, Jae Kyoun (JK); Kim, Dae Hyun (DH); Park, Yeoung Geol (YG); Park, Sang Woo (SW);

Affiliation: Department of Ophthalmology, Chonnam National University Medical School & Hospital, Gwangju, South Korea.

Journal and publication information

Publication Type: Journal Article

Journal: American journal of ophthalmology (Am J Ophthalmol), published in United States. (Language: eng)

Reference: 2009-Nov; vol 148 (issue 5) : pp 794-9

Dates: Created 2009/11/02; Completed 2009/11/05;

PMID: 19665106, status: MEDLINE (last retrieval date: 11/5/2009, IMS Date: )

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