title: Mini-tenotomy procedure to correct diplopia associated with small-angle strabismus.
abstract: OBJECTIVE
  The mini-tenotomy is a novel minimally invasive surgical technique that weakens rectus muscles to treat small-angle strabismus. The mini-tenotomy is an alternative to the standard rectus muscle recession that requires hooking the muscle, suturing the muscle, removing the muscle from sclera, and reattaching the muscle to sclera.
  
  
  METHODS
  This is a retrospective chart review of outcomes of the mini-tenotomy procedure on 15 consecutive adult patients. A central tenotomy of 3 mm was performed cutting through intact conjunctiva using a blunt Westcott scissors.
  
  
  RESULTS
  Preoperatively 6 patients were esotropic, measuring between 2 and 16Delta (mean, 8Delta), and 9 patients had vertical deviations that measured between 2 and 6Delta (mean, 3.5Delta). Final postoperative esodeviations ranged from 1 to 8Delta (mean, 5.8Delta), and hyperdeviations ranged from 0 to 4Delta (mean, 1.3Delta). Final improvement of the deviation was larger for hypertropia, with a mean of 2.3Delta, vs esotropia, with a mean of 1.3Delta.
  
  
  CONCLUSIONS
  The mini-tenotomy is a safe and effective treatment for diplopia caused by a small-angle hypertropia or esotropia. It is a minimally invasive surgery that can be done in office with topical anesthesia. As with any strabismus procedure, more than one surgery may be necessary.
authors.affiliation: Wright Foundation for Pediatric Ophthalmology and Strabismus and the Department of Ophthalmology, University of Southern California-Keck School of Medicine, Los Angeles, California, USA.
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Wright
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004172:Diplopia / Q000209:etiology / Q000601:surgery*; D004948:Esotropia / Q000150:complications; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D009801:Oculomotor Muscles / Q000601:surgery; D013508:Ophthalmologic Surgical Procedures / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery; D013285:Strabismus / Q000150:complications* / Q000503:physiopathology*; D013536:Suture Techniques; D016896:Treatment Outcome