Surgical implications of the superior oblique frenulum

Iizuka, Megumi; Kushner, Burton J.

doi:10.1016/j.jaapos.2007.06.017

Cited by 14 publications

(5 citation statements)

References 3 publications

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“…The superior rectus, inferior rectus, and paralytic horizontal rectus muscles were isolated separately. Care was taken to free the frenulum between the superior rectus and superior oblique muscles [8] and to free the capsulopalpebral lower lid retractors from the inferior rectus muscle. Approximately 1/3 to 1/2 of each muscle belly was sutured between the paralytic horizontal rectus and superior rectus muscles and between the paralytic horizontal rectus and inferior rectus muscles.…”

Section: Methodsmentioning

confidence: 99%

Muscle Union Procedure in Patients with Paralytic Strabismus

et al. 2015

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To present the surgical outcomes of a muscle union procedure in patients with paralytic strabismus, this retrospective study included 27 patients with paralytic strabismus who underwent a muscle union procedure. In this procedure, the two vertical rectus muscles are united with the paralytic horizontal muscle without splitting the muscles. Postoperative ocular deviations, complications, surgical success rates, and reoperation rates were obtained by examining the medical records of the patients. Seventeen patients had a sixth cranial nerve palsy, seven patients had a third cranial nerve palsy, and three patients had a medial rectus muscle palsy after endoscopic sinus surgery. The mean preoperative angle of horizontal deviation in the primary position was 56 ± 21 prism diopters. The mean follow-up period was 12 ± 9 months. The mean final postoperative ocular deviation was 8 ± 13 prism diopters. The success rate was 74%, and the reoperation rate was 0%. No significant complications, including anterior ischemia, occurred in any of the patients. One patient exhibited an increase in intraocular pressure in the immediate postoperative period, but this resolved spontaneously within 1 week. Our muscle union procedure was effective in patients with paralytic strabismus, especially in patients with a large angle of deviation. This muscle union procedure is potentially a suitable option for muscle transposition in patients with paralytic strabismus who have large-angle deviation or a significant residual angle after conventional surgery.

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Section: Methodsmentioning

confidence: 99%

Muscle Union Procedure in Patients with Paralytic Strabismus

et al. 2015

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“…Furthermore, the 'frenulum' between the SO and SR can hinder the SO weakening effect of temporal disinsertion or suspension recession [5]. Debert et al performed 6 mm bilateral SO transection with the complete width from its insertion without frenulum dissection [22].…”

Section: Minimal Disturbance With Visualizationunder a Microscopementioning

confidence: 99%

“…The superior oblique (SO) weakening procedures include tenotomy, tenectomy, recession, and split-tendon lengthening [1]. Tendon scarring due to split-tendon lengthening; a new insertion limiting SO depression due to recession; and uncontrolled effects caused by tenotomy are severe complications that increase the complexity of strabismus conditions [1,2,3,4,5]. The frenulum between the SO and superior rectus (SR) also limits the effects of disinsertion and suspension recession with a temporal approach [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Tendon scarring due to split-tendon lengthening; a new insertion limiting SO depression due to recession; and uncontrolled effects caused by tenotomy are severe complications that increase the complexity of strabismus conditions [1,2,3,4,5]. The frenulum between the SO and superior rectus (SR) also limits the effects of disinsertion and suspension recession with a temporal approach [5,6]. Intrasheath tenotomy or tenectomy of the SO tendon is advantageous because it prevents SO paralysis to the greatest extent possible and achieves more predictable results because the cut ends remain within the sheath [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Modified Superior Oblique Intrasheath Tenectomy in a-pattern With Superior Oblique Overaction  

Sun

Wang²,

Xia³

2021

Preprint

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Background: To evaluate the effect of modified superior oblique intrasheath tenectomy (MSOIT) on superior oblique overaction (SOOA) with A-pattern.Methods: We retrospectively reviewed the data of 66 patients (130 eyes) with SOOA and A-pattern underwent MSOIT at the nasal border of the superior rectus under an operating microscope between January 1, 2004 and December 31, 2018.. The preoperative and postoperative SOOA, objective torsion, ocular motility, and A-pattern deviation findings were compared. The correlation between the preoperative A-pattern deviation and the corrected deviation was analysed. All patients were followed up for more than 12 months. Results: The superior oblique (SO) tendon fibres were resected, and the sheath was preserved in all patients. The average follow-up period was 33.45±29.88 (range: 12–122) months. The mean SOOA deviation improved from 2.95±0.54 to 0.34±0.55 (P < 0.001), while the A-pattern deviation difference between upgaze and downgaze improved from 23.15±7.64 prism dioptres (PD) to 3.50±2.90 PD (P < 0.001). The average objective fundus intorsion value improved from +2.96±0.58 to +0.38±0.60 (P < 0.001). The magnitude of correction in A-pattern was significantly correlated with the preoperative severity of A-pattern (r = 0.812, P<0.001).Conclusions: MSOIT at the nasal border of the superior rectus (SR) under an operating microscope is safe and yields beneficial outcomes in patients with SOOA and A-pattern.

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“…14 To minimize the risk of this complication, most surgeons use separate sterile drapes, instrument trays, bottles of balanced salt solution, and viscoelastic agents when performing surgery in each eye. It has also been recommended that the balanced salt solution and viscoelastic agent used for each eye be obtained from different batches to minimize the risk of an infection arising from a manufacturing error.…”

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confidence: 99%

Toxic anterior segment syndrome after pediatric cataract surgery

Lambert

2010

Journal of American Association for Pediatric Ophthalmology and

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Surgical implications of the superior oblique frenulum

Cited by 14 publications

References 3 publications

Muscle Union Procedure in Patients with Paralytic Strabismus

Muscle Union Procedure in Patients with Paralytic Strabismus

Modified Superior Oblique Intrasheath Tenectomy in a-pattern With Superior Oblique Overaction

Toxic anterior segment syndrome after pediatric cataract surgery

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Surgical implications of the superior oblique frenulum

Cited by 14 publications

References 3 publications

Muscle Union Procedure in Patients with Paralytic Strabismus

Muscle Union Procedure in Patients with Paralytic Strabismus

Modified Superior Oblique Intrasheath Tenectomy in a-pattern With Superior Oblique Overaction&nbsp;&nbsp;

Toxic anterior segment syndrome after pediatric cataract surgery

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Modified Superior Oblique Intrasheath Tenectomy in a-pattern With Superior Oblique Overaction