Description of surgical modification for heavy eye syndrome
Reviewed by Fiona Rowe

For heavy eye syndrome, these authors report a modification to facilitate approximation of the widely separated muscles using a combination of zip-up and hand-over-hand manoeuvres. Ten patients underwent this surgery with unification of the superior rectus and lateral rectus muscles. Two were excluded due to insufficient data and follow-up. Seven had unilateral heavy eye and one was bilateral – all had unilateral surgery. Mean age at surgery was 60.8 years, and mean axial length was 33.2 ±1.2mm. Median preoperative best corrected visual acuity was 2.0 logMAR. Mean follow-up was for six months. Preoperatively mean horizontal angle of deviation was 78 ±20PD and vertical was 34 ±4PD, with -4 or -5 limitations of elevation and abduction. Postoperatively, mean horizontal angle of deviation was 6 ±9PD and 4 ±6PD vertical. Seven patients were <8PD, four had normal elevation and abduction, and three had -1 limitations of elevation and abduction. The success rate was 87%.

Zip-up loop myopexy in heavy eye syndrome.
Awadein A, Farag CS, Maher S.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2024;61(4):279–86.