Tendon Expansion with Fascia Lata in Treatment of A-Pattern Strabismus due to Superior Obliaue Overaction

Background: in 1991, wright described a superior obliqueexpander procedure for browns syndrome and superior overactionwith good results. originally, this procedure has been performedwith silicone band expander. the aim of this study wasto report the results of treatment of a series of patients with apatternstrabismus associated with overacting superior obliquemuscle using the fascia lata tendon expander technique.methods: a total of 12 patients with bilateral overaction ofthe superior oblique muscle and a-pattern strabismus weretreated with bilateral superior oblique lengthening with fascialata according to the values recommended by wright. fascialata was harvested through a iineal incision on the lateral aspectof the patients' thigh.results: the follow-up was 4 to 51 months (mean, 28.8 ± 20.7months). mean superior oblique overaction improved from 3.5± 0.8 before surgery to 0.8 ± 0.9 after surgery (p<0.001). meana-pattern improved from 26.4 ± 8.5 po to 1.7 ± 7 pd(p<0.001), and subjective intorsion improved from 6 ± 0.7 degreeto 0.3 ± 1.1 degree (p<0.001) . one patient developed overcorrection.none of the patients developed recurrence.conclusion: the fascia lata tendon spacer is a useful procedurein the treatment of a-pattern strabismus due to superior obliqueoveraction . this technique may be superior to posterior tenectomybecause of less incidence of superior oblique overactionrecurrence; however, the operation time is longer.