Superior oblique split tendon elongation for Brown's syndrome: Long-term outcomes.

Abstract

To report the outcomes of superior oblique split tendon elongation in Brown's syndrome. Charts of 17 consecutive Brown's syndrome patients who underwent superior oblique split tendon elongation were reviewed and clinical data regarding preoperative, intraoperative, and postoperative data were collected. About 17 eyes of 17 children with congenital Brown's syndrome underwent superior oblique split tendon elongation between January 2012 and March 2020 by a single surgeon. Mean age at surgery was 5.47 ± 2.82 (range 1.50-13.2). Eight (47.1%) were female. Preoperative deficit of elevation in adduction was -4 in all children. At the end of surgery, all eyes were freely elevated on adduction, on forced duction test. Mean follow-up time of 26.24 ± 11.22 (range 11-53) months. In 15 of 17 children (88.2%), motility improved, orthotropia in primary position was achieved, and head posture eliminated (p < 0.001). Superior oblique palsy occurred in two children, who after reoperation, achieved an acceptable outcome. No intraoperative complications were recorded. The superior oblique split tendon elongation procedure is a useful surgical technique with stable and satisfying outcomes for the treatment of severe congenital Brown's syndrome.