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Strabismus -  Reoperation in congenital ET patient Lecture 47 of 54  NEXT»

"A patient had a congenital ET of about 75 PD. She had her surgery, but still had a residual of about 30 PD. A colleague had suggested a three muscle procedure. I did not take the advice. What would be the best procedure for a reoperation?
If the angle of deviation is large; for example, more than 60 PD, you might want to consider three muscles. For the very largest deviations I have even done four muscles.


Eugene M. Helveston, M.D.

"If one does a three muscle procedure which I suspect I should have done in the first instance, what guides the choice of the eye to have the third muscle done?"

There is no hard and fast rule about which eye gets the "third muscle". If everything is equal about the eyes, then it could be either. If there is some difference with ductions or preferred fixation, you could choose the third muscle surgery on that basis. But mostly, no difference.

Eugene M. Helveston, M.D.



Lecture 47 of 54 «Previous Lecture   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54    Next»
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