Abstract

SO.13.01

Fadenoperation – indications beyond esotropia and surgical results

Michael P. Schittkowski
Bereich Strabologie, Neuroophthalmologie und okuloplastische Chirurgie, Abteilung Augenheilkunde, Universitätsmedizin Göttingen, Göttingen

Background
A Fadenoperationen is a well-known surgical option for the treatment of esotropia. To the best of our knowledge there are only a few reports available dealing with this particular topic.
Patients and Method
Retrospective series of patients in whom between 2000 and 2007 a fadenoperation was performed under all indications except esotropia. 21 patients (9 Grave’s disease, 9 third nerve palsy, 1 sixth nerve palsy, 1 muscle dystrophy, 1 orbital trauma) were included.
Results
3 out of the 9 Grave’s patients 4 were operated on the lateral external muscle (1 patient bilateral), which resulted in horizontal enlargement of the zone of binocular single vision of 10-20° (mean 15°). The remaining 6 Grave’s patients were operated on the inferior (n=4) or on the superior (n=2) muscle. This reduced diplopia 10-30° (mean 20°).
Comparing the non-Grave’s patients there were better results in partial third nerve palsies (15-45°, mean 24°) than in complex third nerve palsies (0-20°, mean 11°)
There were no complications so far and none of the patients worsened with the surgery.
Conclusions
A Fadenoperation might help to increase the field of binocular single vision in cases of restrictive squint like Grave’s disease or in paralytic strabismus. The success rate depends from the underlying pathology.

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