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


METHODS
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.
Heo
Hwan
H
Department of Ophthalmology, Chonnam National University Medical School & Hospital, Gwangju, South Korea.
Lee
Kwang Hoon
KH
Ahn
Jae Kyoun
JK
Kim
Dae Hyun
DH
Park
Yeoung Geol
YG
Park
Sang Woo
SW
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D013285:Strabismus / Q000503:physiopathology / Q000601:surgery*; D013710:Tendons / Q000601:surgery*; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult