Microsurgery on Superior oblique

1. Ze Wang¹
2. Chunhua Sun²

¹Nanjing South East Eye Hospital, Nanjing, China
²Tianjin Eye Hospital, Tianjin, China

Purpose Studying on searching for tendon and fibers of the superior oblique（SO） with operating microscope.

Methods The surgeon sited at the superior side of the patient's head. The procedure was performed under low power magnification(4×). To perform intrasheath tenectomy and transposition with trochlea fractured, the fornix conjunctiva was opened beside the nasal border of the superior rectus (SR). After hooking SR, an assistant depressed the globe toward infratemporal position, the surgeon displaced the conjunctiva and Tenon's capsule toward opposite position with deep retractor(made by the writer). In deep orbit, a pearly white , glistening string can be confirmed as SO. It can be hold with forceps. the number of these two procedure were 2 and 99. To perform SO tuck and Harada-Ito procedure, the fornix conjunctiva was opened beside the temporal border of the SR . An assistant depressed the globe toward infranasal position, the surgeon displaced the conjunctive and Tenon's capsule toward opposite position, searched for SO on sclera along with temple of the SR, the argentine or pink with white horizontal fibrous structure can be confirmed as SO.

Results All 116 procedures were successful. There was no failure in finding aponeurosis or tendon of SO. No complication occurred such as injuring of vortex vein, prolapse of orbital fat , tearing SR, or iatrogenic ptosis.

Conclusion It is more easy and safe to find SO with microscope.