Superior Rectus and Ptosis
During taking bridle suture if one is getting ptosis then certainly lps and it’s attachments are getting damaged.. I have made a very quick model of eyeball and SR attachment..sending one video clip..I know it is very crude but the point which I want to stress is clear..in the first part belly of of SR is held while in the second SR tendon is held or SR is held at insertion…. to explain from this model.. when one holds away from insertion eyeball rotates less… When held at the insertion I.e. where the ribbon is glued to the ball, ball rotates better and loose end of the ribbon moves less..
SR bridle suture is blamed for ptosis after cataract surgery..this happens when improperly hooked SR suture causes damage to attachments between SR and LPS.. when belly is hooked traction passes more backwards and as the globe is not rotated more traction is exerted and in the bargain lps attachment with SR are severed albeit minimally..
We routinely follow technique showed in this video… Needle is passed through SR tendon at its insertion at globe. Because of this globe is manaevured without giving traction on posterior part of the muscle and this I feel will reduce the damage to LPS