Fat-wrapping technique markedly improved eye movement in most patients with muscle scarring.
Novel technique for treating extraocular muscle adherence after fracture repair.
Geoffrey E Rose, Kaveh Vahdani
The British journal of ophthalmology · 2026
Background
To describe a technique for treating extraocular muscle adherence after failed fracture repair(s).
Methods
Retrospective review of patients referred with persistent diplopia after prior release of inferior rectus from an orbital fracture.
n = 17 patients
10/17
Results
10/17
eye movement improved a lot after the fat-wrapping surgery
n = 17 patients
More results
Tissues from seven patients showed muscle infiltrated by gross fibrosis extending from the capsule around the underlying implant.
Four patients had poor outcomes due to major parabulbar adhesions, with two out of four being referred with longstanding surgical fistulae in the lower fornix and/or lacrimal sac.
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Conclusion · 1 of 2
After release from adhesions at the site of prior fracture repair(s), fat-wrapping of the outer surface of the inferior rectus muscle can markedly improve binocular single vision fields, ocular ductions and deviations.
Conclusion · 2 of 2
Restoration of a viable extraconal fat layer appears to provide a 'fluid' medium between freed muscle and the orbital wall and block further adhesion between the two raw surfaces but the technique has limited results where prior surgery has caused adhesions involving the lower fornix or pre-equatorial tissues.