Transposition procedures involve redirection of the paths of the EOMs. In the treatment of sixth nerve palsy, Duane retraction syndrome, and monocular elevation deficiency, these procedures utilize 1 or both muscles adjacent to the abnormal muscle to provide a tonic force vector (Video 14-11). The effect of the transposition can be augmented by resecting the transposed muscles or by using offset posterior fixation sutures (Foster modification). Vertical deviations are a possible complication of vertical rectus muscle transposition surgery. Transposition of only the superior rectus muscle, combined with recession of the medial rectus muscle, can also be effective.
Strabismus surgery: lateral rectus and medial rectus inferior full-tendon transfers.
Courtesy of John D. Ferris, FRCOphth, and Peter E. J. Davies, FRANZCO, MPH.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.