Strabismus Surgery: Exploration and/or Repair of Detached Extraocular Muscle(s)

Name of the Procedure:

Strabismus Surgery, Extraocular Muscle Repair, Muscle Reattachment Surgery Also referred to technically as

Summary

Strabismus surgery involves the correction of misaligned eyes by manipulating the extraocular muscles — the muscles outside the eyeball responsible for eye movements. When a muscle detaches from its proper position, it may need to be explored and repaired to restore normal eye alignment and function.

Purpose

The primary purpose of this surgery is to correct misaligned eyes, which can cause double vision, poor depth perception, and difficulty with coordination. The expected outcome is the restoration of proper eye alignment, improved vision, and alleviation of symptoms related to strabismus.

Indications

• Double vision (diplopia)
• Misaligned eyes (strabismus)
• Poor depth perception
• Strain or discomfort due to eye misalignment
• Failed previous surgeries that resulted in muscle detachment

Preparation

• Fasting: No food or drink for 6-12 hours prior to surgery
• Medication adjustments: Certain medications may need to be stopped a few days before surgery
• Preoperative assessments: Eye examination, imaging studies, and general health screening

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure comfort.
2. Incision: A small incision in the conjunctiva (the clear tissue covering the white part of the eye) is made.
3. Exploration: The surgeon explores the area to identify the detached muscle.
4. Reattachment: The detached muscle is reattached to the sclera (the white part of the eye) using fine sutures.
5. Closure: The conjunctival incision is closed, and the eye is typically covered with a protective patch.

Tools and equipment used may include surgical microscopes, fine sutures, and specialized instruments for delicate eye surgery.

Duration

The procedure typically takes between 45 to 90 minutes, depending on the complexity of the case.

Setting

Strabismus surgery is usually performed in a hospital or an outpatient surgical center.

Personnel

• Surgeon: Ophthalmologist specialized in strabismus surgery
• Nurses: Assisting with preparation and postoperative care
• Anesthesiologist: Administering anesthesia and monitoring vital signs

Risks and Complications

• Common risks: Infection, bleeding, minor swelling
• Rare risks: Persistent eye misalignment, double vision, adverse reaction to anesthesia, need for additional surgeries

Benefits

• Immediate benefits: Improved eye alignment, better vision and depth perception
• Long-term benefits: Enhanced quality of life, reduced eye strain, and improved cosmetic appearance

Recovery

• Post-procedure care: Keeping the eye patch in place as directed, applying prescribed eye drops, avoiding strenuous activities
• Recovery time: Most patients return to normal activities within a week. Full recovery and stabilization of eye alignment may take several weeks.
• Follow-up: Regular follow-up appointments to monitor healing and eye alignment.

Alternatives

• Eyeglasses or prism lenses: To help align the eyes temporarily
• Botulinum toxin injections: Used to paralyze an overactive muscle temporarily
• Occlusion therapy: Patching of the stronger eye to improve alignment
• Pros and cons: While less invasive, these alternatives may not provide a permanent solution compared to surgery.

Patient Experience

• During the procedure: The patient will be under general anesthesia and will not feel anything.
• After the procedure: Some discomfort, mild pain, and temporary double vision may be experienced. Pain management includes prescribed medications and cool compresses to alleviate swelling and soreness. Most patients report significant improvement in symptoms and overall satisfaction with the results after recovery.