AIM: To investigate the surgical methods of Helveston syndrome.

METHODS: Fifteen cases(30 eyes)with Helveston syndrome were studied. Surgical method was selected according to the degree of superior oblique muscle overaction and dissociated vertical deviation(DVD).

RESULTS: Binocular superior oblique intrathecal tenectomy was performed in 8 patients(16 eyes). Follow-up period after surgery was 1-3a. Those 8 patients got A-sign correction, of which 3 patients(6 eyes)got DVD vanished and 5 patients(10 eyes)got DVD alleviation. None of the 8 cases needed another operation for DVD. Binocular superior rectus recession and binocular lateral rectus recession with vertical offsets was performed in 4 patients(8 eyes). Follow-up period after surgery was 1-3a. The 4 patients got A sign correction and with orthophoria, of which 1 patient(2 eyes)got DVD vanished and 3 patients(6 eyes)got DVD alleviation. None of the 4 cases needed another operation for DVD. Binocular lateral rectus recession and vertical offsets was performed in 3 patients(6 eyes). Follow-up period after surgery was half a year, with orthophoria, no A sign, DVD weakened, and no second operation was needed.

CONCLUSION: Surgical procedures for Helveston syndrome can be selected according to the degree of superior oblique muscle overaction and DVD.