The fat adherence syndrome and strabismus after retina surgery

The etiology of persistent strabismus after retina surgery has been poorly understood. Seven patients with acquired restrictive strabismus after retina surgery were surgically explored for the cause of the strabismus. In each case, the fat adherence syndrome was identified as playing a significant role in causing the restriction. In four patients, restriction secondary to the fat adherence syndrome was the sole cause of the strabismus. Other contributing causes included a misplaced muscle in two patients and a sponge under a muscle in one patient. Our conclusion is that the fat adherence syndrome is an important cause of restrictive strabismus after retina surgery and that this complication can be minimized by avoiding surgical maneuvers that violate Tenon's capsule and expose extraconal fat.