What's new in strabismus surgery ? Dr. Samer Hajjo

Bioadhesive substances Fibrinogen glue for conjunctival closing “good results” Adal -1 : a new substance for muscle – sclera adhesion “good results initially “

Heavy Eye Syndrome Heavy eye syndrome = (Esotropia + Hypotropia) + High Myopia The real mechanism couldn't be recognized until 1997 High accuracy MRI shows altering in traction axes of the extraocular muscles and especially downward displacement of the LR

Heavy Eye Syndrome

Surgery for Heavy Eye Syndrome Simple myopexy of the LR Splitting of the SR and suturing the lateral with the whole LR

Minimally Invasive Strabismus Surgery MISS Very small conjunctival incision at each edge of the rectus muscles

My conjuctival incision for recess – resect surgery Full peritomy (360°) but without relaxing incisions

My conjuctival incision for recess – resect surgery Deep opening of the four intramascular membranes then the eye will move freely under the conjunctiva

My conjuctival incision for recess – resect surgery At the end of surgery cauterization of minimum power behind the edge of the conjunctiva will make it shrink markedly

My conjuctival incision for recess – resect surgery Whatever the number of muscles we operate, the closure will need just one knot

My conjuctival incision for recess – resect surgery

My conjuctival incision for recess – resect surgery This technique in strabismus surgery is published for the first time It offers a very wide surgical field and facilitate some difficult procedures such as extremely large recessions , posterior fixation , muscles transposition … No changes in normal conjunctival anatomy , no conjunctival scares or cysts The discomfort after surgery my be more then it in other techniques but this will be reversed after few days

The End Thank you