Tears in the Tenon capsule with prolapse of orbital fat into the sub-Tenon space can cause formation of a fibrofatty scar that may restrict ocular motility. Surgery involving the inferior oblique muscle is particularly prone to this complication because of the proximity of the fat space to the posterior border of the inferior oblique muscle. If recognized at the time of surgery, the prolapsed fat can be excised and the rent closed with absorbable sutures. Meticulous surgical technique usually prevents this serious complication.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.