Special form of strabismus – Brown's syndrome. Diagnostics and surgical treatment

Abstract

Purpose. Clarification of indications for surgical treatment of Brown syndrome, choice of the optimal type of surgery and tactics of treatment of secondary overaction of the ipsilateral inferior oblique muscle (IO). Material and methods. Authors evaluate the effectiveness of various types of the superior oblique muscle (SO) weakening procedures based on the analysis of the results of surgical treatment of 65 patients (69 eyes) with Brown syndrome. In 53 cases, tenectomy was performed, and in 16 cases, recession/prolongation of SO. Results. Tenectomy of SO is more effective in surgical treatment of Brown syndrome. In 60 out of 65 (92%) operated patients it was possible to significantly improve the mobility of the operated eye upwards. Secondary overaction of the inferior oblique muscle was eliminated in next step of surgery. Conclusions. Surgical treatment of Brown's syndrome is staged. Indications for surgical treatment are: significant head abnormal position, hypotropia in the primary gaze and in adduction, binocular vision disturbance. The SO tenectomy has provided good functional results in treatment of patients with Brown's syndrome. Key words: Brown's syndrome, incomitant strabismus, superior oblique muscle, surgical treatment, tenectomy, recession, anterior transposition