Modified Faden operation 朅 new surgical technique

Faden operation was first described in 1912. It weakens the muscle in its field of action without much slackening and alteration in the primary position. When combined with recession the weakening effect is more. It is a useful surgery in esotropia with high accommodative convergence, nystagmus blockage syndrome, dissociated vertical deviation, Duane's retraction syndrome with up or downshoots, and in sixth nerve paresis, where it is performed on the contralateral normal yoke muscle to increase the field of binocular vision. The conventional procedure is cumbersome due to small working space, entanglement of sutures, and posterior location of Faden site which is not easily accessible. We have modified the Faden operation by using a single 5-0 double-armed polyester suture, which is much easier and simpler to perform, and have done it in a series of small angle esotropias combined with recession. This paper demonstrates the surgical technique so that this surgery can be performed with ease by more surgeons.

One Muscle Surgery on the Small Angle Esotropia

Twenty patients with small angle esotropia of 12 delta - 20 delta were treated with a unilateral medial rectus recession of 4.0 - 5.0 mm. Eighteen of the 20 patients(90%) showed 8 delta or less horizontal deviations after surgery. The average amount of angle corrected with 4.0 mm recession in 15 delta esotropia group was 15 delta that with 4.5 mm recesstion in 15 delta - 20 delta esotropia group was 14.8 delta and that with 4.5 - 5.0 mm recession in 20 delta esotropia group was 15.2 delta. The average amount of angle corrected with 4.0 mm, 4.5 mm, 5.0 mm recession were 12 delta, 15 delta and 14.6 delta respectively. The recession of one medial rectus muscle is a safe, predictable and simple procedure for the surgical treatmont of small angle esotropia.

One Muscle Surgery on the Small Angle Esotropia

Twenty patients with small angle esotropia of 12 delta - 20 delta were treated with a unilateral medial rectus recession of 4.0 - 5.0mm. Eighteen of the 20 patients (90%) showed 8 delta or less horizontal deviations after surgery. The average amount of angle corrected with 4.0mm recession in 15 delta esotropia group was 15 delta, that with 4.5mm recesstion in 15 delta - 20 delta esotropia group was 14.8 delta and that with 4.5 - 5.0mm recession in 20 delta esotropia group was 15.2 delta. The average amount of angle corrected with 4.0mm, 4.5mm, 5.0mm recession were 12 delta, 15 delta and 14.6 delta respectively. The recession of one medial rectus muscle is a safe, predictable and simple procedure for the surgical treatmont of small angle esotropia.