23 Classic Strabismus Surgery: Rectus Muscle
Marilyn B. Mets Summary Surgery of the rectus muscles is the most common form of strabismus surgery performed. An understanding of anatomy, careful planning, and excellent surgical technique are required…
35 Transpositions
Irene H. Ludwig and Lionel Kowal Summary Transposition of an extraocular muscle shifts its insertion to change its mode of action. Transposition procedures are usually used to treat deviations resulting…
32 Adjustable Sutures and Hang-Back Suture Technique
Maria Felisa Shokida Summary Strabismus surgery remains a challenge because success rates are not always predictable. The adjustable sutures technique has been available to strabismus surgeons for the last several…
31 Injection Technique
Alan Scott, Seyhan B. Oezkan, and Talita Namgalies Summary In adults using topical anesthesia, both botulinum toxin type A (BTXA) and bupivacaine (BUP) are readily injected using electromyography (EMG). Medial…
30 Pulley Surgeries
Irene Ludwig and Yair Morad Summary Procedures developed in recent years using knowledge of the orbital pulleys, as well as directly correcting pulley abnormalities, include pulley posterior fixation and equatorial…
27 Stretched Scar Repair and Management of Other Weak Collagen Abnormalities
Irene Ludwig Summary Genetic or acquired collagen and healing disorders cause several difficulties during strabismus surgery. Sutures may not hold well in tissue and pull through. Tissues may tear during…
29 Traumatic Strabismus Repair (Flap Tear, Slipped and Lost Muscles)
Irene Ludwig Summary There are four types of flap tear: longitudinal, lamellar, beveled, and retracted. Recognition and repair requires familiarity with the normal anatomy of the rectus muscle as well…
26 Superior Oblique Surgical Techniques
Irene Ludwig, Monte Stavis, and Donny Suh Summary The superior oblique tendon is approached at its insertion in the superotemporal quadrant, or at its ropelike tendon superonasally, adjacent to the…
28 Managing Excessive Scar Tissue (Adhesive Syndrome)
Irene Ludwig and Malcolm Ing Summary Fibrosis and scarring may affect alignment directly due to muscle contracture and indirectly via connective tissue restriction and conjunctival shortening. Techniques to correct alignment…
20 Traumatic Strabismus: Direct Orbital and Muscle Trauma and Flap Tear
Irene Ludwig Summary Blunt trauma to the head and face may impact the orbital rim, transmitting avulsive force to the eye muscle pulleys and then to the eye muscles themselves….
