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. 2015:2015:470473.
doi: 10.1155/2015/470473. Epub 2015 Apr 12.

SR and LR Union Suture for the Treatment of Myopic Strabismus Fixus: Is Scleral Fixation Necessary?

Carol P S Lam  1 , Jason C S Yam  1 , Flora H S Lau  1 , Dorothy S P Fan  2 , C Y Wong  1 , Christopher B O Yu  1 , Winnie W Y Lau  1
Affiliations

SR and LR Union Suture for the Treatment of Myopic Strabismus Fixus: Is Scleral Fixation Necessary?

Carol P S Lam et al. Biomed Res Int. 2015.

Abstract

Purpose: To evaluate and compare the effectiveness of scleral fixation SR and LR union suture and nonscleral fixation union suture for the treatment of myopic strabismus fixus.

Methods: Retrospective review of 32 eyes of 22 patients with myopic strabismus fixus who had undergone union suture of superior rectus (SR) and lateral rectus (LR) with or without scleral fixation, and follow-up longer than 6 months at Hong Kong Eye Hospital from 2006 to 2013. Surgical techniques and outcomes in terms of ocular alignment are analyzed.

Results: There is significant overall improvement both in postoperative angle of esodeviation (P < 0.01) and postoperative range of movement (P = 0.042). Comparing between the sclera fixation group (11 eyes) versus nonscleral fixation group (21 eyes), the postoperative horizontal deviation, the postoperative vertical deviation, successful outcome, and the change in horizontal deviation were not significantly different (P > 0.05).

Conclusions: Union suture of SR and LR is an effective procedure in correcting myopic strabismus fixus. Fixation of the union suture to the sclera does not improve surgical outcome.

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Figures

Figure 1
Figure 1
Coronal cut of computed tomography of the orbit of a patient showing superotemporal herniation of the eyeball with inferior displaced LR and nasally displaced SR muscles.
Figure 2
Figure 2
(a) The LR and SR muscles were identified through a forniceal conjunctival incision in the superotemporal quadrant and traction sutures were placed onto the LR and SR muscles. (b) The first union suture joining the superior half of the LR and temporal half of the SR at 10 mm after muscle insertion using 5-O nonabsorbable polyester suture; (c) the second union suture is made similarly at 15 mm after muscle insertion using 5-O nonabsorbable polyester suture.
See this image and copyright information in PMC

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