Bilateral lateral rectus recession of 7.5 mm

PREOPERATIVE DIAGNOSIS:                Exotropia.

POSTOPERATIVE DIAGNOSIS:             Exotropia.

PROCEDURE:                                             Bilateral lateral rectus recession of 7.5 mm.

ANESTHESIA:                                             General.

COMPLICATIONS:                                     None.

PROCEDURE IN DETAIL:                        The patient was wheeled into the operating room suite, placed on the operating room table, where a routine preop cardiac monitoring was initiated.  IV was inserted into place.  The patient was induced with face mask anesthesia, intubated, and maintained on appropriate mixture of gases for general anesthesia.  Both eyes were prepped and draped in a sterile fashion.  Lid speculum was placed into the left eye.  Double-armed 6-0 silk was passed through the 6 and 12 o’clock limbus and clamped maintaining the eye in the abducted position.  Conjunctival incision was performed over the muscle and dissected posteriorly.  Lateral rectus was isolated on a muscle hook and a double-armed 6-0 Vicryl was passed through the muscle 1 mm from the insertion and locked at the superior and inferior poles.  Muscle was disinserted from the globe with blunt Westcott.  Hemostasis was maintained with a disposable cautery.  With 7.5 mm on the calipers as measured back from original insertion site, two needles were passed through sclera at this point.  Muscle was pulled up to the new position and tied.  Needles were cut.  Conjunctiva was passed back in place and sutured with 6-0 plain.  Bilateral sutures removed, lid speculum was removed.  The eye was cleaned and TobraDex was also instilled to the eye.  Then turning to the right eye, the exact same procedure was performed.  There is a lateral rectus recession of 7.5 mm.  The patient was weaned from anesthesia and returned to recovery room in good condition.