First Intraoperative Trochlea Reconstruction.

Area of Science:

• Ophthalmology
• Surgical Innovation
• Muscle Physiology

Background:

• Traumatic superior oblique muscle (SOM) detachment from the trochlea is an exceptionally rare injury.
• Such injuries can lead to significant visual disturbances, including cyclovertical diplopia, particularly in downgaze.

Observation:

• A patient presented with persistent cyclovertical diplopia in downgaze, stemming from a traumatic trochlear injury sustained over four decades prior.
• The long-standing nature of the injury presented unique challenges for surgical intervention.

Findings:

• For the first time, a surgical technique involving the reconstruction of the trochlea using a silicone tube was successfully employed.
• This innovative approach effectively reattached the superior oblique muscle to its functional pulley system.

Implications:

• This case demonstrates a viable, long-term solution for managing rare traumatic superior oblique muscle detachments.
• The silicone tube reconstruction technique offers a new method for restoring ocular motility and improving patient quality of life after severe trochlear damage.