A New Transconjunctival Muscle Reinsertion Technique for Minimally Invasive Strabismus Surgery

Abstract

To describe a novel, minimally invasive strabismus surgery (MISS) technique for horizontal rectus muscle recessions, plications, and advancements. Subjects for this prospective study were the first 20 consecutive patients who underwent unilateral horizontal rectus muscle surgery with a transconjunctival suturing (TRASU) technique for primary muscle displacements of 4.5 mm or greater or for repeat muscle displacements of 3.0 mm or greater. The TRASU technique was associated with no increase in complication rate and was accomplished through a conjunctival approach with an incision that was smaller by 31% ± 11% compared to incisions for previously described MISS approaches. Of the 19 patients (20 eyes) returning for follow-up, 11 (55%) had minimal redness as the only grossly visible sign of surgery on the first postoperative day. By 6 months postoperatively, visual acuity and refractive error were not significantly different from preoperative values (P > .10 for each). The TRASU technique is safe and can be accomplished through a conjunctival incision that averages two-thirds the size of incisions for previously reported MISS techniques.