Direct Surgery of Paretic Oblique Muscles

Superior Oblique Palsy: A Review of 135 Cases

“…Advantages of the superior oblique tucking operation are that it straightens the head, reduces hyper-deviation and it has no effect on the width of the lid fissure. In our series overcorrection is rare and unusual (6).Under-correction is due to failure in pre-op testing to elicit full deviation that had been hidden by fusion, or can be related to the fear of overcorrection or to not knowing how much to tuck. Relatively few precautions must be taken to avoid the so-called Brown's syndrome, limiting elevation in adduction.…”

Superior Oblique Palsy: A Review of 135 Cases

“…Advantages of the superior oblique tucking operation are that it straightens the head, reduces hyper-deviation and it has no effect on the width of the lid fissure. In our series overcorrection is rare and unusual (6).Under-correction is due to failure in pre-op testing to elicit full deviation that had been hidden by fusion, or can be related to the fear of overcorrection or to not knowing how much to tuck. Relatively few precautions must be taken to avoid the so-called Brown's syndrome, limiting elevation in adduction.…”

Surgical Outcomes Following Rectus Muscle Plication

“…24,25 However, contemporary English literature has generally favored tendon-to-tendon plication for the superior oblique and resection for the rectus muscles as standard approaches to strengthening. 2,13,[24][25][26][27][28] Reasons for these choices are uncertain, but different approaches probably evolved in various parts of the world. We found a paucity of comparative studies for relative surgical advantages, and the available literature does not compare quantitative dose effects.…”

When and how to strengthen the superior oblique muscle

“…In 1946 Foster 5 reported a tendon ''reefing'' procedure, a plication attached at the tendon insertion, which he suggested was more physiologic. McLean modified these techniques by sewing the tendon to itself as well as the sclera, 6 describing what amounts to a combined SO tendon tuck and plication. He importantly advocated a temporal approach to the tendon, thereby avoiding disinsertion of the SR muscle.…”

Superior Oblique Palsy: A Review of 135 Cases

“…Advantages of the superior oblique tucking operation are that it straightens the head, reduces hyper-deviation and it has no effect on the width of the lid fissure. In our series overcorrection is rare and unusual (6).Under-correction is due to failure in pre-op testing to elicit full deviation that had been hidden by fusion, or can be related to the fear of overcorrection or to not knowing how much to tuck. Relatively few precautions must be taken to avoid the so-called Brown's syndrome, limiting elevation in adduction.…”

Surgical Outcomes Following Rectus Muscle Plication

“…24,25 However, contemporary English literature has generally favored tendon-to-tendon plication for the superior oblique and resection for the rectus muscles as standard approaches to strengthening. 2,13,[24][25][26][27][28] Reasons for these choices are uncertain, but different approaches probably evolved in various parts of the world. We found a paucity of comparative studies for relative surgical advantages, and the available literature does not compare quantitative dose effects.…”

When and how to strengthen the superior oblique muscle

“…In 1946 Foster 5 reported a tendon ''reefing'' procedure, a plication attached at the tendon insertion, which he suggested was more physiologic. McLean modified these techniques by sewing the tendon to itself as well as the sclera, 6 describing what amounts to a combined SO tendon tuck and plication. He importantly advocated a temporal approach to the tendon, thereby avoiding disinsertion of the SR muscle.…”

Superior Oblique Palsy: A Review of 135 Cases

“…Advantages of the superior oblique tucking operation are that it straightens the head, reduces hyper-deviation and it has no effect on the width of the lid fissure. In our series overcorrection is rare and unusual (6).Under-correction is due to failure in pre-op testing to elicit full deviation that had been hidden by fusion, or can be related to the fear of overcorrection or to not knowing how much to tuck. Relatively few precautions must be taken to avoid the so-called Brown's syndrome, limiting elevation in adduction.…”

Surgical Outcomes Following Rectus Muscle Plication

“…24,25 However, contemporary English literature has generally favored tendon-to-tendon plication for the superior oblique and resection for the rectus muscles as standard approaches to strengthening. 2,13,[24][25][26][27][28] Reasons for these choices are uncertain, but different approaches probably evolved in various parts of the world. We found a paucity of comparative studies for relative surgical advantages, and the available literature does not compare quantitative dose effects.…”

When and how to strengthen the superior oblique muscle

“…In 1946 Foster 5 reported a tendon ''reefing'' procedure, a plication attached at the tendon insertion, which he suggested was more physiologic. McLean modified these techniques by sewing the tendon to itself as well as the sclera, 6 describing what amounts to a combined SO tendon tuck and plication. He importantly advocated a temporal approach to the tendon, thereby avoiding disinsertion of the SR muscle.…”