Superior oblique muscle full tendon advancement surgery early results

The records of 16 eyes of 13 patients were retrospectively reviewed in order to evaluate the early outcomes of patients with superior oblique muscle full tendon advancement surgery in superior oblique muscle palsy. Seven of the thirteen cases were female (53.8%) and six were male (46.2%). When the ages of the cases were examined in years, it was seen that four (30.8%) were between 0-6 years of age, six were between 6-12 years (46.2%), and three (23.1%) were 12 years or older. Congenital superior oblique muscle was observed in eleven of the cases (84.6%) and two of the cases were acquired (%15.4). Superior oblique muscle palsy was detected in the four eyes of the thirteen subjects in the right eye (30.8%) and six of them were in the left eye (46.2%), and in three of them were bilateral (23.1%). In our study, superior oblique muscle full tendon advancement was chosen as the surgical method. All cases were performed by the same surgeon and under general anesthesia. The follow-up period of the cases was three months. Success was defined as a shift in the primary position and improvement of the abnormal head position, loss of diplopia, correction of inferior oblique muscle hyperfunction and superior oblique muscle hypofunction. While the amount of deviation detected in the primary position was 18.44Δ (± 10.119) in the preoperative period, it was observed that the deviation of all the cases were lost in the primary position at the postoperative period. Twelve of the thirteen patients (92.3%) had abnormal head position preoperatively, which was completely restored postoperatively. Preoperatively diplopia observed in two cases (15.4%) was observed to be resolved postoperatively. Preoperatively inferior oblique muscle hyperfunction was + 4 ± 0.632 (+ 3, + 5) on average and was maintained at +1 level in four eyes postoperatively and was measured as mean + 0.25 ± 0.447 (0- + 1). Statistically significant results were obtained when the results of two different periods were compared (p <0.01). Superior oblique muscle hypofunction was -2.19 ± 0.655 (-3, -1) preoperatively, and postoperatively it remained at -1 level in three eyes and it was found -0.19 ± 0.403 (-1.0) averagely. The difference was statistically significant (p <0.01). Preoperatively the mean of torsional grade was +1.75 ± 0.775 (+1, +3). Postoperatively it was found in two eyes at -1 level and at one eye in +1 level and the average was -0.06 ± 0.443 (-1, + 1), and the difference was statistically significant (p <0.01). In our study, orbital cellulitis, endophthalmitis, scleral perforation, iatrogenic Brown Syndrome were not seen. According to our early period results; superior oblique muscle full tendon advancement surgery is performed both for congenital and acquired superior oblique muscle palsy to strengthen this muscle; effective, easy, the results were seen as a satisfactory process. However, there is a need for studies that have a longer duration and a greater number of cases.