Lateral Rectus Plication

Video Type: CVideo
  • 2-5 min videos of a particular surgery or technique. These again show major events in the surgery
  • Clearly annotated and narration is a must in these videos
  • These have clear but concise abstracts are not able to be indexed in PubMed
  • Distributed in newsletters, featured on our website and social media
  • Peer reviewed

Author: Michelle Huynh
Published:
Specialties: Ophthalmology, Pediatric Surgery
Schools: Arkansas Children's Hospital, University of Arkansas for Medical Sciences (UAMS)
3 votes, average: 5.00 out of 53 votes, average: 5.00 out of 53 votes, average: 5.00 out of 53 votes, average: 5.00 out of 53 votes, average: 5.00 out of 5 (3 votes, average: 5.00 out of 5)
You need to be a registered member to rate this post.
Loading...

Introduction

Muscle plication is a type of strabismus surgery that aims to tighten an extraocular muscle by partially folding the muscle under or over itself without disinsertion. The patient is a 14-year-old with alternating esotropia, who previously had a medial rectus recession. Therefore, she underwent plication of the lateral rectus muscle for this procedure.

Methods

A conjunctival incision is made in the fornix. Tenon's capsule is dissected to expose the lateral rectus muscle. The lateral rectus muscle is isolated using a Stevens tenotomy hook followed by a Jameson muscle hook. A Stevens tenotomy hook is used to sweep around the muscle to confirm the location of the muscle pole. A caliper is used to mark the predetermined amount of plication, starting at the muscle insertion and marking further posteriorly on the muscle. The muscle is then secured at the location marked by the caliper with a double-armed 6-0 VicrylTM suture with a central bite and double-locking bites at each pole of the muscle. Plication is achieved by bringing the muscle anteriorly and attaching it to the sclera adjacent to the muscle insertion with half-scleral depth bites in crossed-swords fashion. The muscle is tied down to its new location and 6-0 plain gut sutures are used to close the conjunctival incision.

Results

No complications arose during the procedure. Postoperatively, the patient had subconjunctival hemorrhage, injection, and pain that decreased over the following week. Neomycin-polymyxin-dexamethasone drops were applied daily to prevent infection and inflammation. At the three-month follow up, the redness had resolved. The alternating esotropia had improved.

Conclusion

Lateral rectus plication is a safe procedure that can effectively treat esotropia.

By: Michelle Huynh

College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

mhuynh@uams.edu

Surgeons:

Brita Rook, MD

Arkansas Children’s Hospital – Department of Ophthalmology, Little Rock, Arkansas, USA

BSRook@uams.edu

Joseph Fong, MD

Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

JFong@uams.edu

Video was performed at Arkansas Children’s Hospital, Little Rock, AR, USA.

0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply