[New surgical technics in functional esotropias (the thread operation and classical technics)]

The surgical management of functional esotropias is now very different from some years ago with Fadenoperation settled by Cüppers. Indeed this procedure is the only one which can act in a fitted manner on muscular spasms responsible of more than 60% of convergent squints. The simultaneous using of classical technics remains necessary, but in very different way from the custom formely. In the first part of this work, the authors begin to analyze the mechenism of medical rectus recession, and they show that operation doesn't act by a modification in arc of contact as it was always said, but only by a muscular slacking. On the contrary the change in arc of contact is the main factor which intervenes in Fadenoperation, but the muscle exclusion has also an important part. Whereas the effects of Fadenoperation on adduction incomitance are perfectly clear, those on the deviation in primary position still remain very abstruse. A statistical report on 143 cases of operated blocking esotropias shows that often Fadenoperation alone does not bring a complete cure of motor troubles. The authors explain the reasons of these failures and point out the other accurate muscular actions which must be associated to obtain a good result.