Rectus muscle posterior tenon fixation as an inactivation procedure.
OBJECTIVE
To report a surgical technique and the results of rectus muscle posterior Tenon fixation as an inactivation procedure for treatment of Duane syndrome, restrictive strabismus, and long-standing paralytic strabismus, which conventionally require large rectus muscle recession.


METHODS
Prospective, interventional case series.


METHODS
Three eyes in three Duane syndrome patients, one eye in one myopic strabismus fixus patient, one eye in one complete third nerve palsy patient, and one eye in complete sixth nerve palsy patient underwent rectus muscle inactivation by disinsertion and posterior Tenon fixation of its insertion. The main outcome measures were the postoperative eye position in all patients, the presence of upshoot or downshoot on adduction, and, in Duane syndrome patients only, the height of the palpebral fissure.


RESULTS
In Duane syndrome patients, the upshoot and the downshoot were improved markedly, and the height of the palpebral fissure was increased on adduction after the operation as compared with before the operation; the other patients had improved ocular alignment after surgery.


CONCLUSIONS
We believe that rectus muscle inactivation by fixation of its insertion to posterior Tenon is an effective and less invasive technique for achieving profound weakening of a rectus muscle compared with periosteal fixation of the rectus muscle.
Heo
Hwan
H
Department of Ophthalmology, Chonnam National University Medical School and Hospital, Tong-gu, Gwangju, South Korea.
Park
Sang Woo
SW
D002648:Child; D003238:Connective Tissue / Q000601:surgery; D004370:Duane Retraction Syndrome / Q000601:surgery*; D005133:Eye Movements; D005260:Female; D006801:Humans; D008297:Male; D009216:Myopia / Q000150:complications; D009801:Oculomotor Muscles / Q000601:surgery*; D015840:Oculomotor Nerve Diseases / Q000150:complications; D013508:Ophthalmologic Surgical Procedures; D011446:Prospective Studies; D013285:Strabismus / Q000601:surgery*; D013709:Tendon Transfer