Polytetrafluoroethylene (Goretex) for muscle elongation in the surgical treatment of strabismus with restricted motility.
OBJECTIVE
Repeated strabismus surgery as well as eye muscle fibrosis in various forms of strabismus, can be followed by restriction of the motility of the eye. Tendon elongation may be necessary if further improvement of the deviation and duction of the eye muscle is to be achieved. We used polytetrafluoroethylene (Goretex) and looked at its user comfort, compatibility and dose-rate relationship.


METHODS
Three patients with consecutive exotropia after repeated operations for congenital esotropia, two patients with VI nerve palsy and residual head turn after combined convergence operation and one child with congenital fibrosis syndrome underwent muscle tendon elongation with Goretex (7-15 mm) of either the medial or the lateral rectus muscle, which had already been resected and/or recessed in former surgeries. Forced duction under general anaesthesia was restricted in all patients.


RESULTS
The correction of the deviation in primary position (deviation at distance + 3 degrees to - 4 degrees and at near - 1 degrees to - 8 degrees ) and in side gaze was satisfactory and motility was clearly improved. There were no postoperative complications (infection, shrinkage, scarring) and the postoperative results in terms of the angle of deviation and the improvement in motility remained stable for 1-6 years.


CONCLUSIONS
Polytetrafluoroethylene (Goretex) is a good material with which to resolve complicated cases of strabismus in which muscle tendon elongation for bulbus restriction is necessary.
Langmann
Andrea
A
Department of Ophthalmology, Medical University Graz, Graz, Austria. andrea.langmann@meduni-graz.at
Lindner
Susanne
S
Wackernagel
Werner
W
Koch
Martina
M
Hörantner
Robert
R
D000328:Adult; D001672:Biocompatible Materials; D002675:Child, Preschool; D005133:Eye Movements; D005260:Female; D006801:Humans; D008297:Male; D015835:Ocular Motility Disorders / Q000601:surgery*; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D011138:Polytetrafluoroethylene / Q000627:therapeutic use*; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D013285:Strabismus / Q000601:surgery*; D013710:Tendons / Q000601:surgery*; D015348:Vision, Binocular
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene