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…

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…

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…

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…

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…

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…

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…

David Stager Jr. and David Stager Sr. Summary Inferior oblique weakening procedures presented in this chapter include chemodenervation, disinsertion, various myotomies, recessions, myectomy, nasal myectomy, anterior transposition, anterior nasal transposition,…

Monte A. Del Monte Summary The surgical treatment of strabismus usually involves three types of procedures, which can be performed on rectus muscles or oblique muscles. Classical procedures involve variations…