Bilateral posterior tenectomy of the superior oblique muscle for the treatment of A-pattern strabismus

Milan P. Ranka, Grace T. Liu, Julie N. Nam, Marc J. Lustig, Shirah R. Schwartz, Lisabeth S. Hall, Louis E. Furlan, Emily J. Ceisler, Mark A. Steele

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


RESULTS: A total of 73 patients were included. Of these, 46 had esotropia; 27, exotropia. The preoperative A-pattern deviation for the study population was 19.6Δ≤plusmn; 11.4Δ (range, 10-60), with a final postoperative patten collapse of 18.2≤plusmn; 3.6. Superior oblique overaction was 2.3≤plusmn; 0.7 preoperatively and 0.3≤plusmn; 0.7 postoperatively. Overall, 87.7% of patients had a successful collapse of their pattern to≤lt;10Δ following the initial bilateral superior oblique posterior tenectomy, with an additional 4.1% following a second procedure. Of patients with a pattern deviation of≤lt;25Δ, 87.9% had successful collapse of the pattern following 1 surgery, and 86.7% of patients who had a pattern of≤ge;25Δ had successful collapse. Postoperatively, 7 patients demonstrated mild inferior oblique overaction. No surgical complications were noted.

CONCLUSIONS: A uniform dose of bilateral posterior 7/8 tenectomy surgery successfully collapses A-pattern deviations of all magnitudes.

PURPOSE: To evaluate the efficacy of bilateral posterior superior oblique tenectomy for the treatment of A-pattern strabismus due to superior oblique overaction regardless of the magnitude of the pattern.

METHODS: The medical records of patients with A-pattern esotropia or exotropia in the presence of superior oblique overaction who underwent combined horizontal muscle surgery along with bilateral superior oblique posterior 7/8 tenectomy from 2003 to 2013 were retrospectively reviewed. Patients with at least 3 months' follow-up were included.

Original languageEnglish
Pages (from-to)437-440
Number of pages4
JournalJournal of AAPOS
Issue number5
StatePublished - 1 Oct 2014
Externally publishedYes


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