Rectus Recession with Combined Adjustment Suture

In order to compensate for the shortcomings of re-correction or overcorrection of the straight muscle migration surgery, the suture method can be adjusted to adjust the eye position after the general anesthesia is fully awake. This method is mainly used for the migration of 4 rectus muscles, and can also be used for shortening. However, because this method has certain pain, it is only used for post-migration, and experienced physicians can achieve satisfactory results with general post-migration techniques. Therefore, adjusting suture is not a routine surgical method. Treatment of diseases: paralytic strabismus common strabismus Indication 1. Common strabismus, strabismus is large, need to be a super-constant post-migration time. 2. Mild paralytic oblique strabismus, when the antagonistic muscle strength is too strong, it needs to be weakened. 3. Congenital extraocular muscle dysplasia or acquired constrained mechanical eye movement is restricted, the latter needs to be migrated. 4. The rectus muscle that has been operated, the latter needs to be migrated. 5. Asymmetric strabismus caused by endocrine eye disease needs to migrate the latter. 6. Post-retretation surgery for cataract requires post-migration surgery. Contraindications 1. There is a certain amount of pain during adjustment, poor tolerance and non-cooperative. 2. Pediatric and elderly patients. 3. Heart disease patients. Preoperative preparation 1. Preoperative explanation is clear, so that patients understand and cooperate. 2. Others are the same as before. Surgical procedure 1. Make a corneal conjunctival incision. In the vicinity of the limbal incision, the traction suture of the scleral lamina is sutured for pulling the eyeball when adjusting the suture after surgery. 2. 1.5mm behind the muscle attachment point, use 5-0 nylon thread or 6-0 absorbable suture to make two double loop preset stitches, one on each side (can also make a set in the middle) Loop stitch). Because of the need for postoperative traction, it must be secured to prevent off-line. The tendon is then cut from the point of attachment. 3. The preset suture is inserted through the shallow sclera at the trailing edge of the original muscle attachment point, and then passed out from the front edge of the attachment point. The entrances are 5mm apart and the exits are 2mm apart. If a loop of suture is used, the two needles at the needle are separated by 3 to 4 mm, and the two needles at the needle are in the same needle hole. 4. Using a 5-0 black silk thread, at the exit point of the attachment point, enclose the two muscle sutures, hit 3 to 4 knots and tie them firmly, so that the muscle sutures are fixed and can be adjusted. Can pull when. Then tie 3 to 4 knots at the distal end to make a small loop. Pulling the collar allows the slip knot around the muscle suture to slide back and forth along the muscle suture 10 to 15 mm for easy adjustment after surgery. The muscle ends are then adjusted to the designed post-migration position. 5. Open your eyes and observe the eye position. 6. After the conjunctival flap is migrated, suture to the original muscle attachment point to prevent the conjunctival flap from moving forward and covering the slip knot. The migratory conjunctiva can be covered by epithelial cells within 3 weeks. complication There is bleeding in the anterior chamber.