Evidence map›Paper›PMID 24321425›Full record

ArticleJournal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus2013

Biomechanics of superior oblique Z-tenotomy.

Andrew Shin, Lawrence Yoo, Joseph L Demer

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06084442 (Evaluation of The Techniques of Lateral Rectus Muscle Combined Recession With Hang Back and Combined Recession With Z-Tenotomy in Correcting Large-Angle Exotropia), which is not on this map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
1.9field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06084442 naunknown statusnot on this mapstarted 2023, after this paper: background citation

Evaluation of The Techniques of Lateral Rectus Muscle Combined Recession With Hang Back and Combined Recession With Z-Tenotomy in Correcting Large-Angle Exotropia

TypeinterventionalSponsorTanta UniversityRan2023 to 2024Enrolled50ConditionsExotropia, Evaluation of Surgical Techniques in Correcting ExotropiaArmsEvaluation of The Techniques of Lateral Rectus Muscle Combined Recession with Hang Back and Combined Recession with Z-Tenotomy in Correcting Large-Angle Exotropia
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 31 citations in OpenAlex.

  1. Functional Anatomy of Ocular Counter-Rolling in Superior Oblique Palsy.Investigative ophthalmology & visual science · 2025
    Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. [History of Superior Oblique Muscle Surgery].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2021
    Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
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  15. Article
  16. Article
  17. Observational
  18. Observational
  19. Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Andrew ShinDepartment of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles; Department of Mechanical and Aerospace Engineering, University of California, Los Angeles.
Lawrence Yoo
Joseph L Demer
University of California, Los Angeles · USDoheny Eye Institute · US

Funding

Vision Research Core at UCLAP30EY000331 · NEI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Gregory Darin Field, DAVID S WILLIAMS · 1985 to 2026
$16.8M
BIOMECHANICAL ANALYSIS IN STRABISMUS SURGERYR01EY008313 · NEI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI JOSEPH Louis DEMER · 1991 to 2026
$15.0M
NEI NIH HHS EY0331NEI NIH HHS EY08313NEI NIH HHS P30 EY000331NEI NIH HHS R01 EY008313
6 · The paper itself

Abstract

backgroundA recent report suggests that 70%-80% Z-tenotomy of the superior oblique tendon is necessary to effectively treat A-pattern strabismus associated with over depression in adduction. To clarify the clinical effect, we compared the biomechanics of Z-tenotomy on the superior oblique tendon, superior rectus tendon, and isotropic latex material.

methodsFresh bovine superior oblique tendons were trimmed to 20 mm × 10 mm dimensions similar to human superior oblique tendon and clamped in a microtensile load cell under physiological conditions of temperature and humidity. Minimal preload was applied to avoid slackness. Tendons were elongated until failure following Z-tenotomies, made from opposite tendon margins, spaced 8 mm apart and each encompassing 0%, 20%, 40%, 50%, 60%, or 80% tendon width. Digitally sampled failure force was monitored using a precision strain gauge. Control experiments were performed in similar-sized specimens of bovine superior rectus tendon and isotropic latex.

resultsProgressively increasing Z-tenotomy of latex caused a linearly graded reduction in force. In contrast, Z-tenotomy of up to 50% in superior oblique and superior rectus tendons caused nonlinear reduction in force transmission that reached a negligible value at 50% tenotomy and greater.

conclusionsZ-tenotomy up to 50% progressively reduces extraocular tendon force transmission, but Z-tenotomy of ≥50% is biomechanically equivalent in vitro to complete tenotomy.

Indexed as

Stress, MechanicalAnimalsBiomechanical PhenomenaCattleModels, AnimalOculomotor MusclesTendonsTenotomyTensile Strength

Identifiers

PMID24321425
PMCPMC3858822
OpenAlexW2099380627

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.