Split rectus muscle modified Foster procedure for paralytic strabismus: a report of 5 cases.

PURPOSE: To describe a new eye muscle surgical technique and its outcome in a small series of patients. METHODS AND STUDY: The Foster augmented rectus muscle transposition procedure, which utilizes posterior "lateral" fixation sutures [retroequatorial scleral myopexy parallel and adjacent to the lateral rectus muscle] to obtain greater effect from the transpositions, is modified, to preserve ciliary vessels, by doing only a partial 75-80% transposition of the rectus muscles, preserving and leaving behind a small portion of the muscle containing a ciliary vessel. RESULTS: In five patients in whom preserving ciliary vessel supply was particularly important, the procedure produced results in improving binocular alignment and motility equal to that of the unmodified Foster augmented transposition. There were no complications or undesirable results. CONCLUSION: The modified ciliary vessel preserving procedure can be applied in most cases and may be especially useful in those where this is a high likelihood of additional eye muscle surgery being necessary in the future.

Laser photocoagulation in preproliferative retinopathy of incontinentia pigmenti.

Incontinentia Pigmenti is a rare, X-linked, dominant disorder in which affected female infants develop characteristic abnormalities of the skin, central nervous system, hair, teeth, and eyes. Ocular abnormalities occur in about 35% of patients and consist of proliferative vitreoretinopathy, retinal detachment, strabismus, cataract, microphthalmia, optic nerve atrophy, and iris hypoplasia. Retinal vascular abnormalities, ranging from peripheral retinal avascularity to neovascular and fibrous proliferation with traction retinal detachment, are the primary cause of severe visual dysfunction in patients. Therapeutic intervention with laser photocoagulation and cryotherapy for the proliferative vitreoretinopathy of incontinentia pigmenti has met with variable success. We report a case in which laser photocoagulation was used at the onset of retinopathy with subsequent resolution of the vasculopathy.