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12. Surgical Techniques for Paralytic and Restrictive Horizontal Strabismus (XII Curso de la SEE)

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SURGICAL TECHNIQUES FOR PARALYTIC AND RESTRICTIVE HORIZONTAL STRABISMUS

Jonathan Holmes

For paretic strabismus, the role of contralateral versus ipsilateral surgery will be discussed. Various types of transposition for complete palsies will be presented, with surgical pearls to maximize success. Complications of transpositions include inducing an undesirable vertical deviation and torsion. Techniques for preventing such complications will be described. Posterior fixation sutures are useful to balance duction deficits, and to treat incomitant deviations. A new technique allows a recession to be adjusted, while maintaining posterior fixation. Discussion of horizontal restrictive strabismus will include post-scleral-buckle surgery, presenting techniques for adjustable recessions while leaving the scleral buckle intact. General principies will be stressed, along with illustrative case examples.

 

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