Postoperative adjustable surgery of the superior oblique tendon

Nitza Goldenberg-Cohen, Kristina Tarczy-Hornoch, David F. Klink, David L. Guyton

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations


Purpose: To describe a surgical procedure for loosening or tightening the superior oblique (SO) tendon that enables bedside adjustment following the surgery, with surgical outcome reported. Methods: A permanent suture separates the two cut ends of the SO tendon, with a sliding noose for adjustment. The noose is accessed by having the patient look up or straight ahead, not down, during adjustment at the bedside. Records of 17 patients who underwent this surgery between June 2000 and January 2003 were reviewed and analyzed for outcome. Results: Seventeen patients, 18 eyes, mean age 43.7 years (range 5.9 to 71 years) had SO surgery with postoperatively adjustable sutures. Twelve eyes of 11 patients had a loosening procedure, and six eyes had a tightening procedure. Seven of the patients had had previous eye muscle surgery, four having had previous surgery on the same SO tendon. All but one patient returned for follow-up examination, ranging from 1.5 to 7 months postoperatively. Torsional imbalances in 12 patients improved in all but two. In four patients with a preoperative A pattern, the A pattern improved from 16 PD to 0 PD on average. In eight patients with vertical misalignment in straight ahead gaze who had no other cyclovertical muscle surgery simultaneously, the mean reduction was 7 PD. All patients except one had improvement in preoperative symptoms. Conclusion: Both loosening and tightening procedures can be performed successfully using a postoperative adjustment technique for the SO tendon.

Original languageEnglish (US)
Pages (from-to)5-10
Number of pages6
Issue number1
StatePublished - Mar 2005


  • Adjustable sutures
  • Strabismus surgery
  • Superior oblique tendon

ASJC Scopus subject areas

  • Ophthalmology


Dive into the research topics of 'Postoperative adjustable surgery of the superior oblique tendon'. Together they form a unique fingerprint.

Cite this