Results of superior oblique posterior tenotomy.

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.