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Equatorial Loop Myopexy in "Sagging Eye" Syndrome: A Case Report

Michela Fresina, Laura Sapigni, Cecilia Benedetti, Giuseppe Giannaccare and Emilio C. Campos

Objective: The origin of acute comitant esotropia, associated with sudden diplopia at distance fixation and binocular single vision for near is unclear. The recent hypothesis that considers divergence paralysis esotropia (DPE) as a mechanical (and not neurological) disease, also called "sagging eye syndrome" (SES) allows a modification of the surgical approach.
Methods: We report a SES case treated with a bilateral lateral rectus muscles sclera fixation at a 10 mm distance from the original insertion.
Results: The day after surgery, and for up to a 6 month follow-up period, the patient remained orthotropic at distance fixation, while fusion was preserved at near fixation.
Conclusion: Equatorial loop myopexy in bilateral sagging eye syndrome is a rapid and safe surgical approach with satisfactory clinical results.