DR. KALYANI DIWALE

, Dr.Ashish Doshi, Dr. PRACHI AGASHE

Abstract

Aim: To present the video of Knapp’s procedure with foster augmentation along with MR recession in a case of MED with concurrent esotropia. Case: 18year old presented with drooping of eyelid and deviation of eye with inability to elevate RE since infancy. There was right ptosis with positive Marcus Gun jaw winking phenomenon. He had 50 PD right hypotropia and 25 PD esotropia. There was restriction of elevation in right eye with normal other ocular movements and poor Bell’s phenomenon. Vertical saccadic movements in the right eye were normal from down to middle which stopped abruptly in midline. FDT demonstrated tight inferior rectus and medial rectus. Modified Knapp’s procedure with inferior rectus recession and medial rectus recession was performed. Patient was orthophoric with mild ptosis and no evidence of anterior segment ischemia.

Conclusion: Modified Knapp’s procedure with medial rectus recession gives good long-term outcome in congenital MED with concurrent esotropia.