title: Trochlea surgery for acquired Brown syndrome.
abstract: OBJECTIVE
  To describe surgical treatment of acquired Brown syndrome by trochlea reconstruction and trochlea adhesiotomy.
  
  
  METHODS
  The medical records of patients with acquired Brown syndrome who underwent intraoperative forced duction testing under direct view of the trochlea from 2010 to 2012 were retrospectively reviewed. In all cases, the site of restricted movement was identified, after which either the trochlea was reconstructed or the trochlear adhesion was removed. Surgical results were assessed by means of the pre- and postoperative Hess chart scores and binocular single vision test scores.
  
  
  RESULTS
  Six eyes of 6 patients were included. In 4 patients the trochlea was reconstructed; in 2, the adhesion was removed. A significant improvement in the Hess chart scores was observed postoperatively in 5 of the 6 patients (P = 0.047). Binocular single vision test scores also significantly improved in 4 of 5 patients (P = 0.019). No iatrogenic superior oblique muscle paresis was observed in any of the patients.
  
  
  CONCLUSIONS
  Our technique of isolating the source of limitation of elevation and treating with trochlea reconstruction or adhesion removal successfully treated acquired Brown syndrome in these patients.
authors.affiliation: Department of Ocular Plastic & Orbital Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan. Electronic address: kokubong@hotmail.com.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kokubo
authors.affiliation: Department of Ocular Plastic & Orbital Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
authors.forename: Nobutada
authors.initials: N
authors.lastname: Katori
authors.affiliation: Department of Ocular Plastic & Orbital Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Kasai
authors.affiliation: Department of Ocular Plastic & Orbital Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Hayashi
authors.affiliation: Department of Ocular Plastic & Orbital Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Kamisasanuki
mesh_terms: D000293:Adolescent; D000368:Aged; D002675:Child, Preschool; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000503:physiopathology / Q000601:surgery*; D009801:Oculomotor Muscles / Q000601:surgery*; D012189:Retrospective Studies; D013710:Tendons / Q000601:surgery*; D015348:Vision, Binocular / Q000502:physiology