Securing extraocular muscles in strabismus surgery: biomechanical analysis of muscle imbrication

An experimental study was performed to quantitatively evaluate the tensile strength of extraocular muscle imbrication as it relates to the positioning of the imbricating suture. The study was conducted in a controlled fashion using fresh ex vivo pig eyes with extraocular muscles attached and a precision digital force gauge. The study provides clinically translatable data to inform surgical technique regarding secure muscle imbrication. Results suggest that imbrications performed 0.5 mm or less from the cut muscle edge or 0.5 mm or less from the lateral margin may be prone to tensile failure.