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Superior oblique tendon damage resulting from eyelid surgery
Burton J Kushner1, Jitendra N Jethani
1Department of Ophthalmology and Visual Sciences, University of Wisconsin Hospital and Clinics, Madison, WI 53703, USA. bkushner@facstaff.wisc.edu
American Journal of Ophthalmology
|October 24, 2007
Summary
Upper eyelid surgery can damage the superior oblique (SO) tendon, leading to SO palsy or Brown syndrome. Surgeons must consider SO tendon anatomy during superomedial eyelid procedures.
Area of Science:
- Ophthalmology
- Oculoplastics
- Surgical Anatomy
Background:
- Eyelid surgery, including ptosis repair, tumor removal, and blepharoplasty, is common.
- The superior oblique (SO) tendon is crucial for eye movement and can be vulnerable during surgery in the superomedial orbit.
Observation:
- A retrospective case series identified seven patients who developed SO tendon damage after upper eyelid surgery.
- The damage manifested as ipsilateral SO palsy in four patients and Brown syndrome in three.
Findings:
- The causative eyelid procedures varied, including ptosis correction (4 patients), tumor removal (2 patients), and cosmetic blepharoplasty (1 patient).
- Damage to the SO tendon is a potential complication of various upper eyelid surgical interventions.
Implications:
- Awareness of SO tendon anatomy is critical for surgeons operating in the superomedial aspect of the upper eyelid.
- Preventing SO tendon damage can help avoid debilitating visual and motility disturbances.
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