Abstract
Four eyes of three adult patients underwent anterior transposition and advancement of the superior oblique tendon without trochleotomy in the surgical management of oculomotor nerve palsy. In each of the cases, this procedure proved unsatisfactory, either because of inadequate horizontal alignment, postoperative hyperdeviations, or paradoxical ocular movements. Even in these difficult cases, “supermaximum” horizontal rectus muscle surgery appeared to result in satisfactory ocular alignment.
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