Trochlea surgery for acquired Brown syndrome.

Area of Science:

• Ophthalmology
• Strabismus Surgery
• Ocular Motility Disorders

Background:

• Acquired Brown syndrome presents a challenge in ocular motility, often requiring surgical intervention.
• Accurate diagnosis of the restrictive site is crucial for successful treatment.
• Traditional treatments may not always address the underlying mechanical restriction.

Observation:

• This study retrospectively reviewed 6 patients with acquired Brown syndrome treated between 2010 and 2012.
• Surgical techniques included trochlea reconstruction or trochlear adhesion removal.
• Intraoperative forced duction testing under direct trochlear view guided the surgical approach.

Findings:

• Trochlea reconstruction was performed in 4 patients, and adhesion removal in 2.
• Postoperative Hess chart scores significantly improved in 5 of 6 patients (P = 0.047).
• Binocular single vision improved significantly in 4 of 5 patients (P = 0.019), with no iatrogenic superior oblique palsy.

Implications:

• This surgical approach offers a viable solution for acquired Brown syndrome.
• Accurate identification and treatment of the restrictive mechanism are key to successful outcomes.
• The described techniques provide a safe and effective method for restoring ocular alignment and function.