Results and complications in 66 cases using a silicone tendon expander on overacting superior obliques with A- pattern anisotropias.

PURPOSE

To supplement limited reports in the literature of the results (outcome)and complications of this procedure with our own recent experience.

METHODS

A total of 66 patients with bilateral overaction of the superior oblique and A-pattern strabismus plus 5 patients with a unilateral overacting superior oblique secondary to inferior oblique palsy were treated with a 7 mm silicone expander.

RESULTS

The fist group of 66 patients had an average preoperative A-pattern of 39.6 prism diopters with an average correction of the A-pattern from the surgery of 36.3 prism diopters.

COMPLICATIONS

Of all 137 operations in these 71 patients, three patients had a sterile orbital cellulitis postoperatively successfully treated with steroids. Also, one patient acquired a Brown's Syndrome-like condition postop'. In these four patients, the sub-Tenon's capsule space had been inadvertently entered during surgery. In addition one unilateral superior oblique palsy occurred postoperatively.

CONCLUSION

While this procedure has a very high success rate, special care should be taken with this surgery to avoid entering the sub-Tenon's capsule space.