Measured Tendon Lengthening

The relative frequency of scleral perforation during strabismus surgery and its definite, though small incidence of serious complications suggest that marginal myotomy should have a definite role in muscle weakening. Yet it is seldom used, mainly because of the difficulty in grading the amount of weakening as can be done with a recession. As an alternative to marginal myotomy or recession in patients with abnormally thin sclera, we have used a measured tendon-lengthening procedure that combines the smoothly graded and predictable responses of recession with the safety of marginal myotomy.