title: Surgical outcomes in correction of Brown syndrome.
abstract: OBJECTIVE
  To evaluate the outcomes of surgery for Brown syndrome.
  
  
  METHODS
  We 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.
  
  
  RESULTS
  Nine 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%).
  
  
  CONCLUSIONS
  LEA 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.
authors.affiliation: Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea earth317@yahoo.co.kr
authors.forename: Yoonae A
authors.initials: YA
authors.lastname: Cho
authors.forename: Soo
authors.initials: S
authors.lastname: Kim
authors.forename: Michael H
authors.initials: MH
authors.lastname: Graef
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D005133:Eye Movements / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015835:Ocular Motility Disorders / Q000503:physiopathology / Q000601:surgery*; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D019919:Prosthesis Implantation / Q000295:instrumentation; D012826:Silicone Elastomers; D013577:Syndrome; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D012826:Silicone Elastomers