OBLIQUE FADENOPERATION

Background The mechanical principle of Clippers' Fadenoperation consis ts in reducing the lever arm and in lengthening the are of contact. We describe herein a surgical procedure that abides by this principle bu t creates an oblique Line of adherence of the muscle to the sclera. Pa tients and Methods Five patients were operated on (3 for oblique super ior palsy, 1 for orbital floor fracture, 1 for partial IIIrd cranial n erve palsy). Oblique retroequatorial fixation was applied on 4 inferio r recti and on 1 superior rectus. Fixation was achieved with 5.0 prole ne, the temporal suture being placed 14 mm behind the original inserti on and the nasal one 12 mm behind the original insertion. Results In 4 patients, Fadenoperation of the inferior rectus muscle placed in an o blique way satisfactorily reduced the vertical deviation. The amount o f reduction was comparable to what could be expected of a classic post erior fixation at 13 mm behind insertion. In addition, a slight reduct ion of excyclotropia in downgaze was noted. Conclusion No anatomical f act seems to speak against an oblique setting of sutures when performi ng Fadenoperation of the inferior rectus, and this procedure can be ap plied to cases with incomitant vertical deviation and slight excyclotr opia in downgaze.