Superior rectus and lateral rectus muscle union surgery in the treatment of myopic strabismus fixus: three sutures versus a single suture

Purpose To compare results of superior rectus and lateral rectus muscle union surgery (SR–LR union) performed using three sutures versus a single suture in the treatment of myopic strabismus fixus. Methods The medical records of patients who underwent SR–LR union for myopic strabismus fixus between July 2012 and August 2014 were retrospectively reviewed. The primary outcome measures were changes in ocular deviation and degree of limitation of ocular motility. Results A total of 20 eyes of 10 patients were included: 6 patients in the three-suture group and 4 in the single-suture group. At final follow-up, mean esotropia in the three-suture group improved from 93.3Δ ± 23.5Δ to 21.6Δ ± 8.7Δ ; in the single-suture group, from 102.5Δ ± 15.5Δ to 50Δ ± 9.1Δ . Mean hypotropia improved in the three-suture group from 13.8Δ ± 4.6Δ to 1.6Δ ± 1.9Δ ; in the single-suture group, from 14.25Δ ± 4.3Δ to 3Δ ± 2.5Δ . Mean abduction limitation in the three-suture group decreased from −3.6 ± 1.3 to −0.9 ± 0.6; in the single-suture group, from −4.3 ± 1.1 to −3.12 ± 0.8. Mean limitation of elevation decreased in the three-suture group from −3.1 ± 1.3 to −1.4 ± 1.08; in the single-suture group, from −3.7 ± 1.2 to −2.8 ± 0.5. Conclusions In this cohort of myopic strabismus fixus patients, three-suture SR–LR union was superior to single-suture surgery in improving esotropia and limitation of ocular motility.