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Lateral rectus posterior fixation suture.

Jonathan M Holmes1, Sarah R Hatt, David A Leske

  • 1Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 55905, USA. holmes.jonathan@mayo.edu

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|May 11, 2010
PubMed
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A posterior fixation suture on the lateral rectus muscle effectively treated incomitant exodeviations in a small case series. This surgical technique improved eye alignment in patients with strabismus.

Area of Science:

  • Ophthalmology
  • Strabismus Surgery

Background:

  • Posterior fixation sutures on the lateral rectus muscle have been questioned for efficacy due to the muscle's arc of contact.
  • This study investigates a modified posterior fixation suture technique for lateral rectus muscle recession.

Observation:

  • Three patients with adduction deficits secondary to prior sinus or scleral buckle surgery were identified.
  • A Mersilene posterior fixation suture was placed 17-19 mm from the lateral rectus insertion.
  • A novel recession technique allowed intraoperative adjustment while maintaining the posterior fixation suture.

Findings:

  • The lateral rectus muscle posterior fixation suture successfully induced a -1 limitation of abduction in the unaffected eye.
  • This resulted in improved incomitance of exotropia and reduced exodeviation angles.

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  • All three patients showed positive outcomes at the 1-year follow-up.

    • Implications:

    • Lateral rectus muscle posterior fixation suture is a viable option for treating incomitant exodeviations.
    • Further research is needed to compare this technique with alternative surgical methods.
    • This approach offers a potential solution for specific strabismus cases previously considered difficult to manage.