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  • Title: Suture Fixation of Globe to the Orbital Wall for Complicated Strabismus.
    Author: Yan J, Wen Y, Wang Z.
    Journal: J Craniofac Surg; 2018 Oct; 29(7):e628-e632. PubMed ID: 29521764.
    Abstract:
    PURPOSE: The aim of this study was to observe the surgical outcomes of suture globe fixation to the orbital wall for patients with complicated strabismus. MATERIALS AND METHODS: The medical records of patients with complicated strabismus who were treated at the Zhongshan Ophthalmic Center of Sun Yat-sen University, Guangzhou, China, from January 2010 to June 2015 were retrospectively reviewed. Routine strabismus surgery was not possible in these cases. Eyes were anchored to the orbital wall by simple strong anastomosis of the extraocular muscle and orbital wall tissues using silk suture, which resulted in slight overcorrection of the ultimate ocular position after anchoring. RESULTS: Eight patients with complicated strabismus received suture globe fixation to the orbital wall in our hospital, including 4 cases of strabismus that occurred after severe orbital injury and/or fracture repair, 2 cases of medial rectus rupture after endoscopic sinus surgery, 1 case of complete third nerve palsy, and 1 case of complete sixth nerve palsy. Five patients were male and 3 female, with age ranging from 20.0 to 57.0 years (mean = 38.1 years). The right eyes were involved in 7 cases and the left in 1 case. Five cases underwent globe fixation to the medial orbital wall, 2 cases to the lateral orbital wall, and 1 case to the inferior orbital wall. After at least 6 months follow-up, preoperative horizontal deviation of 60.625 ± 27.443 prism diopter (PD) (mean ± standard deviation) was reduced to 16.250 ± 12.464 PD. The vertical deviation was reduced from 15.000 ± 12.313 PD to 7.5 ± 5.244 PD. Two patients achieved orthophoria, and although the remaining 6 patients showed some residual strabismus (undercorrection), their appearance was significantly improved. No other surgical complications occurred in these cases. CONCLUSION: Suture fixation of the globe to the orbital wall by flesh-to-flesh anastomosis of the extraocular muscle and orbital wall tissues achieved a desirable surgical result for complicated strabismus.
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