title: Recurrent Brown's Syndrome after Superior Oblique Tendon Recession Treated by Silicone Spacer.
abstract: BACKGROUND
  Undercorrections have been reported after a number of surgical procedures for Brown's syndrome. The reason for late undercorrections is not clear but may be related to the heterogeneous etiology of Brown's syndrome.
  
  
  OBJECTIVE
  We report a patient with late undercorrection after superior oblique tendon recession for Brown's syndrome that was partially relieved by a silicone spacer placed nasally.
  
  
  RESULTS
  We noted on surgical exploration that the superior oblique tendon had attached to the sclera under the nasal border of the superior rectus. Further weakening of the tendon was achieved by a No. 240 band expander that resulted in improvement of adduction in elevation.
  
  
  CONCLUSIONS
  Undercorrections following surgery for Brown's syndrome can be relieved by further weakening the superior oblique muscle. However, as late undercorrections have been reported, the optimal timing of surgery is not certain.
authors.affiliation: a Department of Pediatric Ophthalmology and Strabismus , The Eye Foundation , Coimbatore , Tamilnadu , India.
authors.forename: Muralidhar
authors.initials: M
authors.lastname: Rajamani
authors.affiliation: a Department of Pediatric Ophthalmology and Strabismus , The Eye Foundation , Coimbatore , Tamilnadu , India.
authors.forename: Vidhya
authors.initials: V
authors.lastname: Nagasubramanian
authors.affiliation: a Department of Pediatric Ophthalmology and Strabismus , The Eye Foundation , Coimbatore , Tamilnadu , India.
authors.forename: Christopher
authors.initials: C
authors.lastname: Devaraj
authors.affiliation: a Department of Pediatric Ophthalmology and Strabismus , The Eye Foundation , Coimbatore , Tamilnadu , India.
authors.forename: Ramamurthy
authors.initials: R
authors.lastname: Dandapani
mesh_terms: D002648:Child; D006801:Humans; D008297:Male; D015835:Ocular Motility Disorders / Q000175:diagnosis* / Q000601:surgery; D009801:Oculomotor Muscles / Q000601:surgery*; D012008:Recurrence; D012826:Silicone Elastomers; D013710:Tendons / Q000601:surgery*; D015625:Tissue Expansion Devices
chemical_list: D012826:Silicone Elastomers
keywords: Brown’s syndrome; late undercorrection; silicone spacer