Recurrent Brown’s Syndrome after Superior Oblique Tendon Recession Treated by Silicone Spacer

ABSTRACT

Introduction: Undercorrections have been reported after a number of surgical procedures for Brown’s syndrome. The reason for late undercorrections is not clear but may be related to the heterogeneous etiology of Brown’s syndrome.

Purpose: We report a patient with late undercorrection after superior oblique tendon recession for Brown’s syndrome that was partially relieved by a silicone spacer placed nasally.

Results: We noted on surgical exploration that the superior oblique tendon had attached to the sclera under the nasal border of the superior rectus. Further weakening of the tendon was achieved by a No. 240 band expander that resulted in improvement of adduction in elevation.

Conclusion: Undercorrections following surgery for Brown’s syndrome can be relieved by further weakening the superior oblique muscle. However, as late undercorrections have been reported, the optimal timing of surgery is not certain.

KEYWORDS:

• Brown’s syndrome
• late undercorrection
• silicone spacer

Declaration of interest

The authors have no conflict of interest to declare.