Clinical Results of Modified Muscle Transposition Surgery

ABSTRACT

PURPOSE: To report the clinical experience and surgical results of modified transposition surgery, in which half-width tendons are isolated and sutured into the paralyzed extraocular muscle. METHODS: We retrospectively reviewed the medical records of 6 patients (7 eyes), who had undergone modified transposition surgery to correct severe limitation of eye movement from January 1996 to December 2001. First, we divided the half-width tendons of two rectus muscles adjacent to the paralyzed rectus muscle and disinserted the halves from the sclera. The two half-width tendons were positioned underneath of the scleral insertion of the paralyzed muscle, sutured together and then sutured to the paralyzed muscle. In the case of contracture of the antagonizing extraocular muscle, recession of the antagonist was performed. RESULTS: Five of the six patients showed deviation under 15 prism diopters at primary gaze at distance, while synergistic divergence recurred in the sixth patient. CONCLUSIONS: Modified transposition surgery as described in this paper is thought to be an effective and safe method for correction of paralytic strabismus.