Globe fixation with homologous temporalis fascia transplant for treatment of restrictive esotropia strabismus: an interventional case report and review of the literature

Abstract

Purpose: To report a case of fat adherence complication syndrome after pterygium surgery, sufficiently severe enough to create a recurring significant extraocular motility problem and its ultimate novel and successful management.

Method: A 75 year old man was referred with an acquired large angle esotropia after pterygium surgery. Multiple previous strabismus surgeries to relieve the esotropia had already been performed but failed. Bilateral poor vision obviated complaints of diplopia but his binocular visual field was halved and his vision overall and his motility vision was handicapped by this limited ocular motility in his right eye. We therefore utilized homologous adjacent temporalis fascia transplantation for re-fixation of his frozen esotropic globe in primary position. Result of Surgery: Not only was the esotropia resolved but he also developed and regained some degree of abduction in this eye.

Conclusion: Homologous Temporalis fascia transplant can be used safely, for globe fixation in surgical treatment of severe restrictive strabismus.