In strabismus the patient presents a position of the eyes that is not parallel or more precisely not in agreement with the object being observed. The muscles that control the position of the eyes are 6 for each eyeball and must be synchronized to avoid duplication of the image. It can happen that one or more muscles lose their capacity to contract synchronously. If the deviation is horizontal, there are excellent possibilities for self-correction, while in the vertical shapes there is just a minimal deviation to create an image splitting.
The surgical technique consists of moving the insertion of a muscle forward or backward. There are some indicative tables to evaluate how much a muscle must be moved in relation to the deviation but, especially in adults, this is unpredictable. The technique we prefer to use in these forms is called “suture adjustable technique“. With this method, during the intervention performed under local anesthesia, the muscle is moved and tied provisionally with a node that will be untied and permanently fixed the following day; moreover, on the way of topical anesthesia, an intraoperative orthoptic evaluation can be performed.