Muscle belting An alternative operative procedure for posterior fixation suture.

In posterior rectus belting, a modification of Cüppers' Fadenoperation (posterior fixation suture), a piece of silicone rubber is placed across the medial recti muscles and fixed to the sclera 12 mm behind the insertion. Performed as the only procedure, posterior belting was shown to be effective in 43 patients with excess esotropia at near fixation when bifocals were insufficient. Subsequent reoperations (should they become necessary) are both easier and quicker to perform than when following the standard posterior fixation suture. Secondary recess or resect surgery can be done while leaving the belts in place. B-mode ultrasonographic examination was used to demonstrate differences in anatomical outcome between the two techniques.