Fat Adherence Syndrome
Fat adherence syndrome
is restrictive
type of strabismus
that results from prolapse
of the extraconal
orbital fat into the sub-Tenon’s or
episcleral space during surgery
or following trauma. Exposed extraconal
fat that enters the
episcleral space can come into contact with the
extraocular muscles,
the sclera or other orbital connective tissue
elements. The
entrance of extraconal fat into the
episcleral space occurs due
to a disruption in posterior Tenon’s
capsule, which normally
acts as a barrier to fat entering this
location.
The best method to prevent the development of
fat adherence syndrome
is to avoid damage to posterior Tenon’s capsule
during strabismus
or orbital surgery.
If a defect in
posterior Tenon’s capsule is noted during
surgery, it may be possible to reposition small
amounts of orbital fat
that protrude through a
defect in posterior Tenon’s capsule
back into the extraconal space followed
by closure of the defect.
Surgical treatment of a patient with fat
adherence syndrome
is usually difficult.
The goal of treatment is to align the
eyes in the primary position and restore
the ocular movements
as much as possible.
Most reports in the literature support the
notion that a return of normal ocular
rotations is not possible
in most cases.
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