Strabismus Surgery and Oculomotor Muscle Management

Strabismus surgery encompasses a spectrum of operative techniques designed to restore binocular alignment by adjusting the tension and position of extraocular muscles. Indications range from congenital misalignments and paralytic palsies to traumatic ruptures and anomalous innervation disorders. Core procedures include recession and resection of rectus and oblique muscles, transposition of muscle bellies to redirect force vectors, and novel union or pulley suspension methods to compensate for paralysis or mechanical disruption. Preoperative imaging with high-resolution magnetic resonance imaging or computed tomography guides surgical planning, particularly in cases of nerve absence, muscle rupture or orbital scarring. Adjustable suture techniques permit fine-tuning of alignment postoperatively, while awareness of vascular supply minimises the risk of anterior segment ischaemia. Outcomes are assessed by residual deviation in prism dioptres, motility range, presence of binocular single vision and patient-reported functional gains. Advances in microsurgical repair, biologically inert fixation devices and targeted transposition strategies are extending the safety and efficacy of interventions, with global implications for childhood amblyopia prevention and adult quality of life.

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Strabismus Surgery and Oculomotor Muscle Management publication trend

The graph below shows the total number of articles in strabismus surgery and oculomotor muscle management across all publications each year (not limited to Nature Index journals).

Technical terms

Recession: Surgical weakening of a muscle by detaching and reattaching it further back on the globe.

Resection: Strengthening of a muscle by excising a segment and reattaching the shortened muscle to its original insertion.

Transposition: Transfer of a muscle’s insertion to a new anatomical position to alter its pulling direction.

End-to-end muscle anastomosis: Direct repair of a severed muscle by suturing its cut ends together.

Anterior segment ischaemia: Compromise of blood flow to the front structures of the eye following extensive muscle surgery.

References

1. Isolated Total Rupture of Extraocular Muscles. Medicine (2015).
2. Muscle Union Procedure in Patients with Paralytic Strabismus. PLOS ONE (2015).
3. Superior Oblique Anterior Transposition with Horizontal Recti Recession‐Resection for Total Third‐Nerve Palsy. Journal of Ophthalmology (2015).
4. Anterior Segment Ischemia after Strabismus Surgery. Turkish Journal of Ophthalmology (2017).