2020–2021 BCSC Basic and Clinical Science Course™
6 Pediatric Ophthalmology and Strabismus
Part I: Strabismus
Chapter 14: Surgery of the Extraocular Muscles
Surgical Techniques for the Extraocular Muscles and Tendons
Rectus Muscle Tightening Procedures
Although also referred to as strengthening procedures, muscle tightening procedures (defined in Table 14-4) do not actually give the muscles more strength. Rather, they produce a tightening effect that tends to offset the opposite action of the antagonist muscle. For this purpose, surgeons usually use the resection technique (Video 14-4); typical amounts of surgery for esotropia and exotropia are given in Tables 14-1 and 14-2, respectively. Plication of the muscle can be used as an alternative to produce a similar effect. A previously recessed rectus muscle can also be tightened by advancing its insertion toward the limbus.
Table 14-3 Weakening Procedures Used in Strabismus Surgery
Table 14-4 Tightening Procedures Used in Strabismus Surgery
VIDEO 14-4 Resection of extraocular rectus muscle.
Courtesy of Scott A. Larson, MD, and Johanna Beebe, MD.
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.