Myectomy eye surgery is a surgical procedure for disorders affecting eye movement and eyelid function. The procedure aims to correct conditions where eye muscles are overactive or misaligned, thereby improving both visual function and eye alignment. It is for individuals whose symptoms haven’t responded to other treatments.
Understanding Myectomy Eye Surgery
Myectomy involves the partial removal of an eye muscle. This procedure reduces the muscle’s pull or influence on eye movement, effectively weakening it. It is distinct from other common eye muscle surgeries like recession, where a muscle is detached and reattached further back on the eye to weaken its action, or resection, where a section of the muscle is removed to shorten and strengthen it. This surgical technique is often performed on the extraocular muscles, which are responsible for controlling eye movements, or on muscles around the eyelids.
When Myectomy Is Recommended
Myectomy is for eye conditions with muscle overactivity or spasm. It is commonly indicated for severe strabismus, where eyes do not align properly (e.g., “crossed eyes”). When strabismus has not improved with non-surgical treatments like glasses or eye exercises, myectomy may be recommended. It also treats nystagmus, involuntary eye movements driven by muscle overactivity. Additionally, it treats blepharospasm, involuntary eyelid muscle contractions, especially when botulinum toxin injections are insufficient.
The Surgical Process
Myectomy begins with pre-operative consultations. The surgery is performed under general anesthesia, so the patient is asleep and feels no pain. In some cases, local anesthesia with sedation may be used, particularly for adults. The surgeon makes small incisions in the clear tissue covering the white of the eye, known as the conjunctiva, or around the eyelid to access the affected eye muscles.
Once the muscle is identified, a portion of the overactive or abnormal muscle tissue is carefully removed. This may involve excising parts of the orbicularis oculi and corrugator supercilii muscles for blepharospasm. The amount of muscle removed varies depending on the specific condition and the desired weakening effect. It is usually an outpatient surgery, allowing patients to go home the same day. The duration of the surgery can vary, but it often takes a few hours to complete.
Recovery and Expected Results
Following myectomy eye surgery, patients can expect some immediate post-operative symptoms. Common experiences include swelling, bruising, and mild discomfort around the eyes. The eye may also feel tight or sore, and some temporary blurry vision, dryness, or tearing can occur. These initial effects generally subside within the first week or two. Cold compresses and prescribed pain medication can help manage discomfort and reduce swelling.
Stitches, if non-dissolvable, are typically removed within 5 to 10 days. Patients are advised to keep their head elevated, especially while sleeping, and avoid strenuous activities, heavy lifting, or rubbing their eyes for at least two weeks. While significant improvement in eye alignment or reduction in involuntary movements may be noticeable early on, complete healing can take up to a year. The full effects of the surgery, such as improved eye alignment, reduced nystagmus, or alleviation of eyelid spasms, often become more apparent over several months as the tissues heal and adapt. Follow-up appointments with the surgeon are important to monitor recovery and assess the long-term outcomes.