Search

Purpose: Full tendon rectus muscle transposition surgery augmented with posterior fixation sutures has been shown to be effective in the treatment of abducens palsy and Duane's syndrome. The purpose of this study is to summarize our experience with the use of this procedure and a three fourths partial tendon transposition modification of this procedure for a variety of complex vertical and horizontal paralytic eye movement disorders., Design: Retrospective noncomparative interventional consecutive case series., Participants: Eighteen patients with paralytic strabismus., Intervention: Full tendon rectus muscle transposition procedure augmented with posterior fixation sutures (13 patients) or a three fourths partial tendon transposition augmented with posterior fixation sutures (5 patients)., Main Outcome Measures: Resolution of diplopia in the primary position and improved ocular alignment., Results: Comparing preoperative to postoperative status, presence of primary position diplopia decreased from 64% to 14%, anomalous head posture decreased from 56% to 6%, and primary position alignment improved in all patients., Conclusions: Full tendon rectus muscle transposition surgery augmented with posterior fixation sutures and the vessel-sparing three fourths partial tendon transposition modification of this technique are effective for the treatment of a variety of complex vertical and horizontal paralytic ocular motility disorders.

Purpose: To describe a new eye muscle surgical technique and its outcome in a small series of patients. METHODS AND STUDY: The Foster augmented rectus muscle transposition procedure, which utilizes posterior "lateral" fixation sutures [retroequatorial scleral myopexy parallel and adjacent to the lateral rectus muscle] to obtain greater effect from the transpositions, is modified, to preserve ciliary vessels, by doing only a partial 75-80% transposition of the rectus muscles, preserving and leaving behind a small portion of the muscle containing a ciliary vessel., Results: In five patients in whom preserving ciliary vessel supply was particularly important, the procedure produced results in improving binocular alignment and motility equal to that of the unmodified Foster augmented transposition. There were no complications or undesirable results., Conclusion: The modified ciliary vessel preserving procedure can be applied in most cases and may be especially useful in those where this is a high likelihood of additional eye muscle surgery being necessary in the future.