STRABISMUS SURGERY

Surgical techniques
1. Muscle weakening procedures include recession,
marginal myotomy and myectomy.
2. Muscle strengthening procedures are resection,
tucking and advancement.
3. Procedures that change direction of muscle
action. These include (a) vertical transposition of
horizontal recti to correct ‘A’ and ‘V’ patterns (b)
posterior fixation suture (Faden operation) to
correct dissociated vertical deviation; and (c)
transplantation of muscles in paralytic squints.
Steps of recession (Fig. 13.29)
1. Muscle is exposed by reflecting a flap of overlying
conjunctiva and Tenon’s capsule.
2. Two vicryl sutures are passed through the outer
quarters of the muscle tendon near the insertion.
3. The muscle tendon is disinserted from the sclera
with the help of tenotomy scissors.
4. The amount of recession is measured with the
callipers and marked on the sclera.
5. The muscle tendon is sutured with the sclera at
the marked site posterior to original insertion.
6. Conjunctival flap is sutured back.