The surgical correction of paralytic strabismus using fascia lata

Objective: To present the results of a new technique designed to restore and maintain alignment, exclusively in the primary position, in patients with paralytic strabismus. Methods: In five patients (seven eyes, total) with exotropia secondary to third-nerve palsy, we fixated the globe with a strip of fascia lata sutured onto both the medial aspect of the eye and the nasal bone periosteum. We characterized the ocular deviation in the primary position with prism diopters the day before the operation, during the initial 24-hour period, and at subsequent monthly postoperative evaluations. We documented all evaluations with photographs. Results: In all patients, the ocular position improved with the surgery. No further change of the ocular position was noted during the follow-up period, which ranged from 15 to 35 months (mean follow up 22.5 months). All the patients tolerated the collagenous tissue without complications. Conclusions: This procedure can be a useful addition to the current surgical techniques for management of strabismus secondary to third-nerve paralysis.