Transposition of plicated horizontal muscles

Abstract

Various surgical techniques exist for simultaneous correction of a strabismus with both horizontal and vertical components. Transposition of horizontal muscles is most commonly performed on recessed and resected muscles. We describe a novel surgical technique that combines horizontal rectus muscle plication with a vertical transposition and present a small case series in which the technique was used to successfully correct both horizontal and vertical deviations.

FIG 1.

Combined right medial rectus muscle plication with vertical transposition. A, Suture is passed through muscle edges (arrows). In this case, an 8 mm plication with full-tendon-width transposition was performed. B, The inferior muscle suture (white arrow) is passed through the sclera, anterior to the superior pole of the muscle edge. C, The superior muscle suture (black arrow) is passed through the sclera one full-tendon width (7 mm) superior to the first scleral pass. D, Appearance after sutures are tied, with a triangular fold in the muscle.