Portal de Periódicos da CAPES

Superior oblique tendon spacer with application of nonabsorbable adjustable suture for treatment of Brown syndrome

2008; Elsevier BV; Volume: 12; Issue: 4 Linguagem: Inglês

10.1016/j.jaapos.2007.11.020

1528-3933

Ziaeddin Yazdian, Manijheh Kamali-Alamdari, Mohammad Ali Yazdian, Mohammad Taher Rajabi,

Vascular Malformations and Hemangiomas

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 11.08Δ to 0.32Δ (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. To evaluate the outcomes of a superior oblique tendon spacer procedure using nonabsorbable adjustable sutures in patients with Brown syndrome. 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. 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 11.08Δ to 0.32Δ (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. 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.