Sensory Testing following Adjustable Suture Surgery

Abstract

Four patients with a diagnosis of superior oblique palsy had a symptomatic cyclotorsional deviation with a small or absent vertical deviation.

Surgery performed was an anteriorization and lateralization of the anterior fibers of the superior oblique tendon utilizing an adjustable suture technique. This is a variation of the Harada-Ito procedure described in 1964.

Postoperative adjustment was made utilizing the double Maddox rod technique for measuring cyclotorsion. In patients where excyclotorsion remained, the adjustable suture was tightened; while in patients with resulting incyclotorsion, the adjustable suture was loosened. The endpoint utilized was the patient's observation of parallelism of the red and white lines utilizing the double Maddox rod test.

This technique was successfully used in adjusting four patients who had this surgical procedure. There was no significant torsional shift postoperatively.