Medial or lateral rectus retraction

1. Internal rectus muscle post-migration is suitable for esotropia, especially for obsessive hypertonic esotropia. 2. External rectus muscle migration is suitable for exotropia, especially for exotropia. Treatment of diseases: primary non-regulatory esotropia common exotropia Indication 1. Internal rectus muscle post-migration is suitable for esotropia, especially for obsessive hypertonic esotropia. 2. External rectus muscle migration is suitable for exotropia, especially for exotropia. Contraindications 1. The case where the sclera at the new attachment point is too thin and the needle is easily penetrated into the sclera. 2. The implants or ligatures of the previous retinal detachment surgery are required at the new attachment point after migration. Surgical procedure 1. The conjunctival incision is followed by the migration of the inner rectus muscle: the above-mentioned limbal incision method is used to separate the connection between the bulbar conjunctiva and the fascia of the eyeball. 2. 2 mm outside the attachment point of the medial rectus muscle and 2 mm outside the lower edge, use scissors to cut the eyeball fascia into a small hole and reach the sclera. To fully expose the sclera. And use scissors to reach into the small hole, lightly scleral, along the inner rectus muscle, and then separate the relationship between the fascia and the sclera on both sides of the eye muscle. 3. The squint hook is inserted into the small hole, and the light top sclera slides under the inner rectus muscle and passes through the opposite side hole. If the squint hook is on the eyeball fascia, it can be cut with scissors. This can be repeated from top to bottom, from bottom to top 2 to 3 times, it is necessary to hook the entire internal rectus muscle. 4. The upper and lower edges of the inner rectus muscle attachment point are cut open, and the eyeball fascia, the ligament and the intermuscular membrane are cut open, and the length is about 10 mm, and the inner rectus muscle is fully exposed. 5. 1.5mm behind the point of attachment of the medial rectus, at the upper and lower ends of the tendon, each of the preset tendon 1/3 wide double loop suture, in order to suture the fixed tendon at the new attachment point, the muscle can be made Flattening is better than using a fixed line. 6. Cut the internal rectus muscle from the attachment point. The scissors should be cut 2 to 3 times. Because the tendon attachment point is not straight, the cut will not only lose more tendon but also can not match the shape of the original attachment line. 7. Measure the post-migration distance: Determine the distance after migration with a two-legged rule and immediately press the sclera with one foot of the two-footed foot to make an indentation as a mark or mark it with methylene blue. 8. Fix the suture to the new attachment point of the sclera. 9. Open the binocular examination to check whether the correction is satisfactory and whether the intraocular rotation is limited. If it is not satisfactory, make adjustments or add other eye muscle surgery. 10. Stitch the conjunctiva. complication 1. When suturing the suture, it penetrates the sclera and causes vitreous prolapse and intraocular inflammation. 2. Muscle slippage. Mainly because the suture is too close to the broken end, the scleral tissue through which the needle passes is too small.

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