title: Rectus muscle recession and resection without scleral sutures.
abstract: OBJECTIVE
  To eliminate the risk of scleral perforation during strabismus surgery in susceptible patients, we introduce a technique to allow predictable rectus muscle recession and resection without the placement of scleral sutures.
  
  
  METHODS
  Three patients with thin sclera underwent rectus muscle surgery by use of a double-arm suture technique that avoids placement of sutures directly into the sclera. Two of the patients had esotropia and underwent bilateral lateral rectus muscle resections and a unilateral recess/resect operation, respectively. One of the patients had exotropia and underwent bilateral lateral rectus muscle recessions.
  
  
  RESULTS
  All three patients achieved postoperative alignment to within 15 PD of orthotropia and had no evidence of slipped or lost muscle when examined 2 months postoperatively. The appearance of the ocular surface was excellent in all three cases.
  
  
  CONCLUSIONS
  Predictable and secure rectus muscle recession and resection can be performed without the placement of scleral sutures in patients in whom scleral suturing may be hazardous.
authors.affiliation: Cullen Eye Institute, Baylor College of Medicine, Texas Children's Hospital, Houston 77030, USA.
authors.forename: D K
authors.initials: DK
authors.lastname: Coats
authors.forename: E A
authors.initials: EA
authors.lastname: Paysse
mesh_terms: D000368:Aged; D002648:Child; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D012421:Rupture / Q000517:prevention & control; D012590:Sclera / Q000293:injuries / Q000601:surgery*; D013285:Strabismus / Q000601:surgery*; D013536:Suture Techniques; D015348:Vision, Binocular