Vertical Muscle Transposition with Augmentation for Treatment of Exotropia Caused by Iatrogenic Lost Medial Rectus Muscle

Strabismus. 2016 Jun;24(2):79-83. doi: 10.3109/09273972.2016.1159233. Epub 2016 Apr 29.

Abstract

Purpose: To evaluate the results of vertical muscle transposition with augmentation in cases of exotropia caused by iatrogenic lost medial rectus muscle.

Methods: This is a retrospective review of 5 cases of lost medial rectus with exotropia and marked limitation of adduction that underwent surgery. All cases had a history of strabismus surgery on the medial rectus and failed attempt at retrieval of the lost muscle.

Results: Five patients fulfilled the criteria. Full tendon vertical muscle transposition with augmentation sutures was done for all cases. Surgery led to a significant reduction of the angle of exotropia 25.8±13.6 ?D (P=0.027) and improvement in adduction of 7.5±3.8 degrees (P=0.034). There were no complications.

Conclusions: Isolated vertical muscle transposition with augmentation is a useful option to improve the exotropia and adduction deficit in patients with iatrogenic lost medial rectus muscle.

Keywords: Adult strabismus; exotropia; operation dosage; techniques/procedures.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Exotropia / etiology*
  • Exotropia / surgery*
  • Female
  • Humans
  • Iatrogenic Disease
  • Male
  • Oculomotor Muscles / pathology
  • Oculomotor Muscles / transplantation*
  • Ophthalmologic Surgical Procedures*
  • Retrospective Studies
  • Tendon Transfer*
  • Vision, Binocular / physiology
  • Young Adult