Rectus muscle plication for strabismus surgery final Dr.Amr Mohamed MBBS,CABO,JBO,FICO,FPOS

1. Dr.Amr Abdulaziz Al Maisari
Pediatric ophthalmology & strabismus consultant
MBBS,CABO,JBO,FICO,FPOS
Noor Alyemen Eye center-Sanaa

2. What is plication?
Indications & advantages.
Procedure.
Case presentation.
Take home message.

3.  A muscle-to-sclera plication was developed by Dr. Kenneth Wright.
 It consists of securing posterior muscle, like in a single suture resection.
 Instead of resecting the anterior muscle, the sutures are passed through the
sclera at the insertion, thereby folding the muscle.

4. Conclusion: Plication of horizontal extraocular muscles reveals to be an alternative to
resection in strabismus surgery, with similar results.

5. Indications
 Strengthening procedure and act as an alternative to rectus muscle resection.
Advantages
 Technical simplicity.
 Shorter operating time.
 Less surgical trauma.
 Preservation of anterior ciliary vessels.
 Safety, as there is virtually no chance of a lost muscle.
 Reversibility, by cutting the suture.

15.  20 year old, Male, systemically free.
 Presented with right eye decreased vision and outward and upward
deviation post trauma.
 On Examination :
Right eye Left eye
BCVA hand motion BCVA 6/6
Anterior segment : WNL Anterior segment : WNL
Posterior segment: old RD Posterior segment: WNL

17. PLICATION is the answer !

18. Right eye
SR
Recession
6.5 mm
LR
Recession
8.5 mm
MR plication
6.5 mm
IR
Plicatio
n 5.5
mm

20.  Plication of horizontal extraocular muscles reveals to be an alternative to resection in
strabismus surgery, with similar results.
 Some surgeons and few studies suggest adding 0.5 mm to resection dosage ( specifically in XT).
 It is technically easier in small-moderate resections( up to 6-6.5 mm).