Use of augmented rectus muscle transposition surgery for complex strabismus.
OBJECTIVE
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.


METHODS
Retrospective noncomparative interventional consecutive case series.


METHODS
Eighteen patients with paralytic strabismus.


METHODS
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).


METHODS
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.
Paysse
Evelyn A
EA
Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Texas Children's Hospital, 1102 Bates #300, MC 3-2700, Houston, TX 77030, USA.
Brady McCreery
Kathryn M
KM
Ross
Andrew
A
Coats
David K
DK
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004172:Diplopia / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000637:transplantation*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013285:Strabismus / Q000601:surgery*; D013536:Suture Techniques; D013710:Tendons / Q000637:transplantation; D016896:Treatment Outcome