ABSTRACT
Migration of silicone explants through rectus muscle insertion is a rare complication with very few cases reported. Anterior migration of a solid silicone band may occur if it is tight, placed anterior to the equator or not properly anchored to the sclera. The band slowly erodes through the tendon of one or more recti muscles allowing them to reattach spontaneously with scar tissue behind migrating element. The authors describe a rare case of anterior migration of the buckle following encirclage by a 4mm silicone band resulting in spontaneous disinsertion of medial rectus muscle where muscle disinsertion had not been performed peroperatively. This migration occurred in the absence of any predisposing factors. The muscle disinsertion was so gradual that the muscle got reinserted almost to its original insertion as a result of which there was no heterotropia .