Lost muscle surgery
Reviewed by Fiona Rowe

The authors present the results of transposition surgery without concomitant lateral rectus weakening in a retrospective review of five cases. Surgery was for large exotropia and marked limitation of adduction after surgical loss of the medial rectus muscle. Mean age was 20.4±7.45 years. Surgery involved full tendon vertical rectus muscle transposition with augmentation as the initial correcting procedure. Angle of deviation was a mean of 46.7±9.9PD reducing to 20.8±13.4PD which was significant. No vertical deviation was induced by surgery. Adduction improved by 7.5±3.8 degrees on average which was significant. No surgical complications were reported for this procedure and no restriction on forced duction test was produced.

Vertical muscle transposition with augmentation for treatment of exotropia caused by iatrogenic lost medial rectus muscle.
Elkamshoushy AA, El Sayed DA, Sprunger DT.
STRABISMUS
2016;24(2):79-83.