PURPOSE: Sometimes, a conventional recess-resect surgery may not be sufficient to obtain satisfactory ocular alignment. @entity1 who have previously undergone surgery and/or have a large difference in visual acuity between both eyes and do not wish to undergo surgery on the sound eye provide a surgical challenge. In these cases, tendon elongation with @entity291 pericardium may be an option. METHODS: We retrospectively reviewed the charts of 38 @entity1 who underwent strabismus surgery with tendon elongation. Before surgery, 31 had @entity5770 (angle -21.8    5.7 degrees) and 7 @entity5971 (angle +19.1    5.4 degrees). Reasons for tendon elongation included the following: 15 @entity1 refused surgery on their sound eye; in 15 @entity1 , conventional recess-resect was not possible; and in 7 @entity1 , the elongation best fitted the motility pattern. In one @entity1 , tendon elongation was preferred over conventional recession because of a thin sclera. Follow-up was 0.5 to 4 years. RESULTS: At last follow-up visit, in @entity1 with previous @entity5770 , the angle was -3.3    5.9 degrees; in @entity1 with previous @entity5971 , +0.2    0.5 degrees. Most had some duction limitation in the direction of the elongated muscle. All @entity1 but one were satisfied with the result. In the @entity1 with previous @entity5770 , there was a small but nonsignificant regression to recurrence of the exodeviation (on average 0.5 degree per year). CONCLUSIONS: Tendon elongation is a valuable addition to our strabismus surgery repertoire. However, because of duction limitations after surgery, it should be reserved for those cases in which conventional surgery is not an option.

Tendon elongation with XXXX pericardium (Tutopatch  ) when conventional strabismus surgery is not possible.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity5971 :: ('MESH:D004948', 'Disease') :: ['esotropia'] @entity291 :: ('9913', 'Species') :: ['bovine'] @entity5770 :: ('MESH:D005099', 'Disease') :: ['exotropia']
@entity291 :: (9913,Species) :: ['bovine']
