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Comment & Response
February 2015

Rectus Muscle Plication Procedure—Reply

Author Affiliations
  • 1Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
  • 2Postgraduate Institute of Medical Education and Research, New Delhi, India
  • 3Dr Ram Manohar Lohia Hospital, New Delhi, India
  • 4Stein Eye Institute, University of California, Los Angeles
JAMA Ophthalmol. 2015;133(2):227. doi:10.1001/jamaophthalmol.2014.4263

In Reply We thank Dr Wright for his interest in our recent report of surgical outcomes of rectus plication, a comparatively ancient surgical technique deserving reconsideration after having fallen out of favor in the Americas for historical reasons. Tucking and plication are synonymous terms. Plication of rectus extraocular muscles (EOMs) was reported as early as 1883.1 Reported modifications have included muscle-to-muscle tucking and anterior and posterior suturing to the scleral bed.2 Problems associated with anterior muscle-to-muscle plication may include eventual relaxation of the imbrication and real or anticipated cosmetic blemish putatively produced by the anterior bulk of the advanced EOM. We do not advocate muscle-to-muscle rectus plication. Instead, posterior muscle-to-sclera plication, described in our recent article, has the advantage of folding the plicated tissue between the posterior EOM and sclera and avoids cosmetic blemish.3 Our experience identified no cosmetic disadvantage to plication.

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