Abstract
• Improve ocular movement into the field of the paretic muscles either by increasing the action of the involved muscle through a resection or tucktype procedure, or by creating an alternate force vector (often necessary in complete paralysis) by an extraocular muscle transposition procedure.
• Create matching weaknesses of movement in the yoke muscles of the other eye. Since it is generally impossible to restore normal function to the paralytic muscle, the “normal” eye needs to be matched to whatever resulting function can be achieved in the involved eye.
• Minimize the creation of new deviations by selecting appropriated surgical options.
• The direction of greatest deviation determines which muscles are operated and the quality of the remaining duction (good, fair, poor) helps select what operation to perform.
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Buckley, E. (2009). General Principles in the Surgical Treatment of Paralytic Strabismus. In: Wilson, M., Trivedi, R., Saunders, R. (eds) Pediatric Ophthalmology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68632-3_14
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