Results of superior oblique posterior tenotomy

Abstract

Purpose: The purpose of the study was to evaluate the results obtained by the superior oblique posterior tenotomy close to its insertion in patients with A-pattern strabismus and vertical strabismus who had bilateral or unilateral superior oblique overaction.

Methods: We retrospectively analyzed the results of superior oblique posterior tenotomy close to its insertion performed bilaterally in 13 consecutive patients with A-pattern strabismus and unilaterally in 14 consecutive patients with hypotropia performed between March 1989 and October 1996.

Results: The mean preoperative A-pattern deviation was 25.31 PD and the mean postoperative A-pattern deviation was 3.23 PD with a mean reduction of 22.08 PD. The mean follow-up for the above group was months (range 3 to 58 months). In the hypotropia group the mean preoperative vertical deviation was 11.07 PD and the mean postoperative vertical deviation was 4.28 PD with a mean reduction of 6.78 PD. The mean follow-up for this group was 16.21 months (range 3 to 72 months).

Conclusions: Superior oblique posterior tenotomy selectively weakens its vertical action. Bilateral weakening showed marked and consistent improvement in A-pattern deviation and unilateral weakening showed definite but less consistent reduction in deviation in cases of hypotropia with superior oblique overaction.