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  • Title: Superior oblique tendon spacer with application of nonabsorbable adjustable suture for treatment of Brown syndrome.
    Author: Yazdian Z, Kamali-Alamdari M, Ali Yazdian M, Rajabi MT.
    Journal: J AAPOS; 2008 Aug; 12(4):405-8. PubMed ID: 18396080.
    Abstract:
    PURPOSE: To evaluate the outcomes of a superior oblique tendon spacer procedure using nonabsorbable adjustable sutures in patients with Brown syndrome. METHODS: This noncomparative interventional case series includes 25 eyes of 25 patients with Brown syndrome. In all patients the superior oblique tendon was exposed; two nonabsorbable polyester sutures were placed 4 mm apart, and the tendon was cut. With the use of a slipknot, the cut ends of the tendon were separated 5 to 8 mm. Tendon separation was adjusted intraoperatively according to the exaggerated traction test and indirect ophthalmoscopy. RESULTS: Overall 25 eyes of 25 patients with mean age of 8.00 +/- 4.62 years were operated and followed for a mean period of 13.2 +/- 7.6 months (range, 3 to 30 months). Mean elevation in adduction improved from -3.96 before surgery to -0.67 (p < 0.001); mean hypotropia improved from 11.08(Delta) to 0.32(Delta) (p < 0.001). Two patients developed overcorrection, but recurrence was not observed in any case. The patients continued to improve over the follow-up period. CONCLUSIONS: The adjustable superior oblique tendon suture spacer procedure has favorable results and seems to be technically easier than a silicone expander procedure for Brown syndrome.
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