title: Large-angle strabismus and primary true muscle transplantation.
abstract: BACKGROUND
  Large-angle strabismus often demands a series of surgeries to achieve satisfactory alignment. This often necessitates bilateral surgery, which patients may be reluctant to undergo.
  
  
  METHODS
  Three patients with large-angle esotropia, not amenable to standard recession and resection procedures, underwent primary true muscle transplantation wherein a fragment of resected extraocular muscle was used to elongate the medial rectus muscle.
  
  
  RESULTS
  Postoperative deviation was within +/- 10 PD of orthophoria and was maintained at follow-up of 6 to 12 months. There was mild underaction of the weakened muscle.
  
  
  CONCLUSIONS
  True muscle transplantation is a good option because it permits correction of large-angle strabismus with two-muscle surgery, provides a satisfactory cosmetic alignment, and appears safe and predictable.
authors.affiliation: Institute of Ophthalmology, JN Medical College, Aligarh Muslim University, Aligarh, India.
authors.forename: A K
authors.initials: AK
authors.lastname: Amitava
authors.forename: Anup K
authors.initials: AK
authors.lastname: Goswami
authors.forename: Amit
authors.initials: A
authors.lastname: Mishra
mesh_terms: D000328:Adult; D002648:Child; D004948:Esotropia / Q000601:surgery*; D005133:Eye Movements; D005260:Female; D006801:Humans; D009801:Oculomotor Muscles / Q000637:transplantation*; D013508:Ophthalmologic Surgical Procedures; D013536:Suture Techniques; D015348:Vision, Binocular