[Oblique retro-equatorial myopexy].

BACKGROUND

The mechanical principle of Cüppers' Fadenoperation consists in reducing the lever arm and in lengthening the arc of contact. We describe herein a surgical procedure that abides by this principle but creates an oblique line of adherence of the muscle to the sclera.

PATIENTS AND METHODS

Five patients were operated on (3 for oblique superior palsy, 1 for orbital floor fracture, 1 for partial IIIrd cranial nerve palsy). Oblique retroequatorial fixation was applied on 4 inferior recti and on 1 superior rectus. Fixation was achieved with 5.0 prolene, the temporal suture being placed 14 mm behind the original insertion and the nasal one 12 mm behind the original insertion.

RESULTS

In 4 patients, Fadenoperation of the inferior rectus muscle placed in an oblique way satisfactorily reduced the vertical deviation. The amount of reduction was comparable to what could be expected of a classic posterior fixation at 13 mm behind insertion. In addition, a slight reduction of excyclotropia in downgaze was noted.

CONCLUSION

No anatomical fact seems to speak against an oblique setting of sutures when performing Fadenoperation of the inferior rectus, and this procedure can be applied to cases with incomitant vertical deviation and slight excyclotropia in downgaze.