2020–2021 BCSC Basic and Clinical Science Course™
6 Pediatric Ophthalmology and Strabismus
Part I: Strabismus
Chapter 14: Surgery of the Extraocular Muscles
Surgical Techniques for the Extraocular Muscles and Tendons
Transposition Procedures
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.
VIDEO 14-11 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.