title: A muscle transposition procedure for abducens palsy, in which the halves of the vertical rectus muscle bellies are sutured onto the sclera.
abstract: OBJECTIVE
  To review the results of a muscle transposition procedure in which the halves of the vertical rectus muscle bellies are sutured onto the sclera, without tenotomy of vertical recti as in Hummelsheim's procedure or surgical treatment of the lateral rectus (LR) as in Jensen's procedure.
  
  
  METHODS
  Ten patients with abducens palsy received the procedure. We measured the ocular deviation and the field of single binocular vision, and observed the LR using magnetic resonance imaging (MRI).
  
  
  RESULTS
  Preoperative or postoperative deviation was distributed from +27 to +58 prism diopters (PD) or orthophoria to +12 PD, respectively, in 7 patients with unilateral paresis, and +75 to +120 PD or +2 to +37 PD in 3 patients with bilateral paresis. The average correction was 42.4 PD per eye. Seven patients were able to regain the field of single binocular vision at least in the primary position. No postoperative complications were observed. MRI showed that the LR was atrophic and floppy, lacking muscle tension.
  
  
  CONCLUSIONS
  Our procedure enabled the patients to obtain satisfactory postoperative results without treatment of the LR or tenotomy of the transposed muscles. This procedure can reduce operative damage to the eye more than Hummelsheim's or Jensen's procedure.
authors.affiliation: Department of Ophthalmology, Shiga University of Medical Science, Seta, Tsukinowa, Otsu, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nishida
authors.forename: Akihiro
authors.initials: A
authors.lastname: Inatomi
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Aoki
authors.forename: Osamu
authors.initials: O
authors.lastname: Hayashi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Iwami
authors.forename: Sanae
authors.initials: S
authors.lastname: Oda
authors.forename: Jiro
authors.initials: J
authors.lastname: Nakamura
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Kani
mesh_terms: D020434:Abducens Nerve Diseases / Q000175:diagnosis / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000473:pathology / Q000637:transplantation*; D013508:Ophthalmologic Surgical Procedures; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D015348:Vision, Binocular / Q000502:physiology