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Abstract
Purpose
The authors of the present study compared the effects of tenectomy and posterior tenectomy of the superior oblique for treating superior oblique overaction (SOOA).
Methods
The records of 30 eyes of 19 patients who underwent tenectomy or posterior tenectomy of the superior oblique alone or in combination with surgery on other horizontal rectus muscles from April 2005 through November 2010 were reviewed. The review was performed in 3 patients who underwent unilateral superior oblique tenectomy, 5 patients who underwent unilateral superior oblique posterior tenectomy, 3 patients who underwent bilateral superior oblique tenectomy, 6 patients who underwent bilateral superior oblique posterior tenectomy, and 2 patients who underwent superior oblique posterior tenectomy and tenectomy.
Results
The mean age of the patients was 14.2 years, and the mean follow-up period was 20 months. Through superior oblique tenectomy (11 eyes) and superior oblique posterior tenectomy (19 eyes), the amount of SOOA decreased from +2.27 to +0.09 and from +1.84 to +0.93, respectively. Except for 1 out of 11 eyes with superior oblique tenectomy, SOOA was completely corrected, although SOOA remained in 6 eyes after posterior tenectomy. Therefore, the correctional effects of the 2 methods differed; both procedures showed insignificant correctional effects on vertical strabismus.
Conclusions
Superior oblique tenectomy has a superior long-term weakening effect; however, posterior tenectomy showed a comparable effect in the patient with moderate to severe SOOA. Both of these methods had few complications and are considered to be effective superior oblique weakening procedures.
Figures and Tables
Table 1
Effects of posterior tenectomy and tenectomy of the superior oblique on superior oblique overaction (SOOA)
*Difference of immediate SOOA correctional effect between posterior tenectomy and tenectomy of the superior oblique (p = 0.016, Wilcoxon signed rank test); †Difference of final SOOA correctional effect between posterior tenectomy and tenectomy of the superior oblique (p = 0.018, Wilcoxon signed rank test).
Table 2
Correctional effects of posterior tenectomy and tenectomy of the superior oblique on moderate to severe superior oblique
overaction (SOOA)
*Difference of immediate SOOA correctional effect between posterior tenectomy and tenectomy of the superior oblique (p = 0.077, Wilcoxon signed rank test); †Difference of final SOOA correctional effect between posterior tenectomy and tenectomy of the superior oblique (p = 0.097, Wilcoxon signed rank test).
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