This type of surgery is typically performed in a hospital outpatient surgical facility. During the surgery the eye is never removed! Rather, a small incision is made on the clear membrane covering the white part of one or both eyes. Through this incision, the appropriate surgery is then performed on the surface of the eye to eliminate the strabismus. The inside of the eyeball is not entered during this type of surgery. Contemporary strabismus surgical techniques involve "hidden" incisions, leaving virtually no visible scarring of the eye surface as a result of this surgery.
When strabismus surgery is recommended for a child, the earlier in life it is done the better the chance of the child achieving binocular vision, or "depth perception".
Despite having the appropriate surgery, some patients may require further eye muscle surgery in the months, years or decades following their initial operation to further refine their ocular alignment.
Photograph of child in recovery room following strabismus surgery (two hours after surgery). This child had an esotropia. The tension of the inner muscle of each eye has been relaxed. The ocular surface redness slowly resolves over the course of two weeks.
Before and after (one year later) strabismus surgery in child with congenital esotropia.
Adjustable Suture Surgery For Adults
As with children, adults who undergo eye muscle surgery can usually achieve precise surgical results with standard surgery. There are occasions, however, when such precision is not possible due to the underlying cause of the strabismus, such as scarring from old surgery, inflammation from eye muscle diseases, or neurological weakness. In these cases, it is sometimes advisable to adjust the tension of the muscles postoperatively.
In adjustable suture surgery, the surgery is performed under general anesthesia in the typical fashion except that temporary suture knots are placed. Several hours after awakening from anesthesia, the eye alignment is evaluated. If it is good, permanent knots are tied. If the eyes are not adequately aligned, an adjustment in the muscle tension can be performed. These final steps are completed with the patient awake and the surface of the eye anesthetized with eye drops. When appropriate, this technique can enhance the surgical outcome.
Examples of Treatment
For our patients coming for surgery from outside of the New York Metro area and abroad, our surgical coordinators will assist you in making hotel arrangements during your stay in Manhattan.