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    Medial Rectus Wright Mini Plication

    By Kenneth W. Wright, MD
    Pediatric Ophth/Strabismus

    Dr. Ken Wright demonstrates his mini plication, a simplified procedure for tightening the rectus muscle to achieve 6 to 8 prism diopters of correction. Dissection is carried down to the rectus muscle belly where an initial suture of 6-0 Vicryl is passed and tied in place. Dissection is continued anteriorly, in front of the muscle insertion site where the second suture pass and knot will be made. The sclera is cleared, and the surgeon sutures through the sclera to secure the muscle. By tightening and tying the suture down, the muscle folds or plicates 4-5 mm, producing the desired correction. The procedure can be reversed by simply snipping the suture within 2-3 days following surgery. After this period, however, scarring will ensue. Video adapted from Pediatric Ophthalmology and Strabismus (Oxford University Press, 2012).