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

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

3. 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

4. Heavy Eye Syndrome

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

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

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

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

9. 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

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

11. My conjuctival incision for recess – resect surgery

12. 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

13. The End
Thank you