resection
Resection is a strabismus operation that strengthens a rectus muscle by shortening it, which enhances the muscle's effective pull. The procedure is suitable only for a rectus muscle.1
Two absorbable sutures are placed through the muscle at a measured distance behind its insertion. The muscle in front of the sutures is excised, and the cut end is reattached to the original insertion.1
A resection is often combined with a recession of the antagonist in the same session, which adds to the effectiveness of each procedure and tends to stabilize the result. The resection reduces the contracture that normally develops in the recessed antagonist, so surgeons often add a resection mainly to secure the effect of the recession.2 Millimeter for millimeter, a resection corrects less of the deviation than a recession, so larger resections are needed to match the effect of recessing the antagonist.2
More detail
Resection of the medial rectus ranges from a minimum of 4 mm to a maximum that rarely exceeds 7 or 8 mm, and the lateral rectus is seldom resected less than 4 mm or more than 10 mm. When more correction is needed, the muscle is advanced toward the cornea.2 Plication, or tucking, has an effect similar to resection but is less traumatic, spares the anterior ciliary vessels and can be easily reversed. Plication is now frequently preferred to resection for the rectus muscles.1
Sources (9)
- Kanski, Clinical Ophthalmology (2024), ch. 18
- von Noorden and Campos, Binocular Vision and Ocular Motility, ch. 26
- Agarwal, S. (2020). Strabismus Surgery. In: Agarwal, S. (ed.) Strabismus Simplified. Springer, Singapore. https://doi.org/10.1007/978-981-15-2135-0_9
- Kushner, B.J. (2017). Strabismus. In: Olitsky, S.E. (ed.) Pediatric Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-319-28315-5_10
- Rutstein, R. and Daum, K. (1997). Anomalies of Binocular Vision: Diagnosis & Management. St. Louis: Mosby.
- Saxena, R., Kakkar, A., Menon, V., Sharma, P. and Phuljungan, P. (2003). Evaluation of factors influencing surgical results of horizontal muscle squint surgery. Indian Journal of Ophthalmology, 51(1), pp.39-44.
- von Noorden, G. and Campos, E. (2002). Binocular Vision and Ocular Motility. 6th ed. St. Louis: Mosby.
- AAPOS: strabismus-surgery
- EyeWiki: Strabismus_Surgery_Complications
Reviewed October 2026