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Updated: Oct 13, 2026

Rotating the Intraocular Lens to Prevent Posterior Capsular Opacification in Cataract Surgeries
Published on: July 7, 2023
[Cüpper myopexy as treatment of pseudoptosis; apropos of 2 cases]
1Service Universitaire d'Ophtalmologie Hôpital Ophtalmique Jules Gonin, Lausanne.
Background:
According to Hering's law, the induced palsy of an extraocular muscle will result in an increased innervational flow to this muscle as well as to its contralateral synergist. A retroequatorial myopexy (Cüppers Faden Operation), with or without muscle recession, can be considered as an iatrogenic palsy.
Methods:
Two patients, aged 16 and 5 years respectively, presented with hypotropia, the deviated eye showing limited ocular movements in elevation and pseudoptosis of the upper eye lid. Both patients underwent surgery, this consisting of a posterior fixation and recession of the superior rectus of the sound eye.
Results:
After surgery, both cases showed a stable improvement of the opening of the palpebral fissure and of the vertical deviation.
Conclusions:
This surgical procedure was already described by Cüppers and, although rarely performed, does represent a useful surgical alternative in cases of partial ptosis of the upper eye lid together with hypotropia.

