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Comment & Response |

Rectus Muscle Plication Procedure—Reply

Zia Chaudhuri, MS, FRCS(Glasg)1,2,3; Joseph L. Demer, MD, PhD4
[+] 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.
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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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February 1, 2015
Kenneth W. Wright, MD
1Wright Foundation for Pediatric Ophthalmology and Strabismus, Los Angeles, California2Cedars-Sinai Medical Center, Los Angeles, California3Keck School of Medicine, University of Southern California, Los Angeles
JAMA Ophthalmol. 2015;133(2):226-227. doi:10.1001/jamaophthalmol.2014.4259.
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