Original papers: Electrocautery paraplical incision for Faden operation

In case of Faden operation (Cüppers' operation) without recession of the muscle, the authors looked for a direct approach to the site where the posterior fixation sutures should be placed. They chose a paraplical incision. To prevent bleeding they used electrocautery following a surgical technique previously described. The authors performed electrocautery paraplical incision in 270 eyes of 238 patients (age ranged between 3 y and 55 y). Follow-up time was 2.4 y + 1.3. After electrocautery, preparation of the medial rectus muscle and Faden procedure (without disinsertion of the muscle) were carried out. Finally the conjunctiva was closed with single sutures. In no patient did long-term complications occur and only the following minor complications were observed intra- or perioperatively: in one patient orbital fat protruded during surgery. Postoperatively one eye had a corneal erosion and another severe eyelid edema. In another patient a swollen plica with consecutive putrid secretion was observed. In all three cases symptoms disappeared after therapy. Paraplical incision was even possible after previous strabismus surgery with limbal incision. In Faden operation without recession of the medial rectus muscle, electrocautery paraplical incision is an alternative method with minimal postoperative inflammation and minimal scarring. It allows good approach to the medial rectus muscle, with minimal intraoperative bleeding. Postoperative healing and cosmesis are good.