Partial Augmented Rectus Extraocular Muscles Transpositions

Lateral posterior fixation sutures increase the effect of full rectus extraocular muscle transpositions. Partial rectus muscle transpositions minimize the risk of anterior segment ischemia. Five Duane syndrome patients with esotropia in primary position, and 5 patients with 6^th nerve palsy underwent unilateral split rectus muscle transposition augmented with lateral posterior fixation sutures. Seven cases had history of prior ipsilateral rectus muscle surgery. Three cases underwent simultaneous surgery on ipsilateral horizontal rectus muscles. The angle of deviation significantly improved postoperatively (P>0.001). Postoperative binocular single visual fields enlarged. Partial rectus muscle augmented transposition allows surgery on multiple ipsilateral rectus muscles, improves ocular alignment and enlarges the binocular single field in Duane syndrome patients with esotropia, marked co-contraction and globe retraction, and in 6^th nerve palsy patients with ipsilateral medial rectus tightness.