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Superior oblique split lengthening procedure for brown syndrome, outcomes and complications
  1. Albanderi Alhamzah1,
  2. Mozon F Alshareef2,
  3. Rasha Shabar3,
  4. Shatha Hussein Alfreihi3,4
  1. 1College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
  2. 2King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, Saudi Arabia
  3. 3Pediatric Surgery, Division of Pediatric Ophthalmology, National Guard Health Affairs, Riyadh, Saudi Arabia
  4. 4King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
  1. Correspondence to Dr Shatha Hussein Alfreihi, Pediatric surgery, Division of Pediatric Ophthalmology, King Abdullah Specialist Children Hospital, National Guard Health Affairs, Riyadh 11426, Saudi Arabia; alfreihish{at}ngha.med.sa

Abstract

Introduction To evaluate the outcomes of the superior oblique split tendon lengthening (SOSL) procedure for Brown syndrome (BS).

Methods At a single institution, all patients who underwent SOSL surgery for BS from 2013 to 2019 were reviewed retrospectively. We looked at the surgical outcomes and complications in a total of 20 eyes of 18 patients. The superior oblique (SO) muscle was isolated and then extended. The tendon was then split centrally into equal halves. Two 6–0 polyglactin sutures were then placed on each end of the split tendon 6–10 mm apart. To complete the Z-cut, the split tendon was cut distal to the preplaced sutures. The sutures were then tied to produce the split Z-tendon lengthening.

Results Eleven (55%) out of 20 eyes were female patients. The mean age was 6.6 years (range 2–17 years). The mean follow-up was 26.8 months (range 5–72 months). The mean degree of preoperative limitation of elevation on adduction was −3.6±0.58 preoperatively and −0.75±1.25 postoperatively (p=0.0001). Preoperatively, the mean degree of vertical deviation at near was 3.5±7.62 and at distance was 3.10±7.84 prism diopters (PD), respectively. Postoperatively, the mean vertical deviation was 2.77±4.75 and 2.10±4.08 PD at near and distance, respectively. Postoperative complications included haematoma in one patient (5%), overcorrection in two patients (10%) and one patient required reoperation (5%).

Conclusion SOSL is a safe procedure that surgeons can consider in managing patients with BS.

  • muscles
  • treatment surgery
  • child health (paediatrics)
  • treatment other
  • not applicable

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information. Data are stored in a password-protected computer. Permission of reuse of data should be sought from SHA, alfreihish@ngha.med.sa.

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Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information. Data are stored in a password-protected computer. Permission of reuse of data should be sought from SHA, alfreihish@ngha.med.sa.

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Footnotes

  • Contributors SHA, AA and MFA designed the study. SHA, AA, RS and MFA acquired and analysed the data, which SHA, AA and MFA interpreted. SHA and AA wrote the manuscript, which all authors reviewed and approved for publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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