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Strabismus surgery
Strabismus
Key Points
- •The Spiral of Tillaux defines rectus muscle insertion distances from the limbus (MR 5.5 mm, IR 6.5 mm, LR 6.9 mm, SR 7.7 mm) - essential knowledge for recession measurements and surgical planning
- •Dose-response: approximately 1 mm of recession or resection of a horizontal rectus corrects 2–3 prism dioptres - bilateral symmetric surgery is preferred for comitant deviations
- •Adjustable sutures are the most important quality-improving technique in adult strabismus surgery - especially for restrictive, paralytic, and reoperation cases
- •Anterior segment ischaemia (ASI) risk increases significantly when >2 rectus muscles are operated on the same eye - each rectus carries 2 anterior ciliary arteries (except LR which carries only 1)
- •Reoperation rate is 15–25% overall; surgery on infantile esotropia aims for alignment before 24 months to maximise binocular potential - the best achievable outcome is monofixation syndrome (not bifoveal stereopsis)
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17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations