DR. AMIT KUMAR

DR. AMIT RAJ

Abstract

To report results of Y-splitting and recession of lateral rectus(LR) muscle alongwith split tendon superior rectus(SR) transposition in exo-DRS. Patient presented with exotropia with complete abduction but limitation of adduction with downshoot during attempted adduction. However, intraop, we found a lax LR muscle. Despite lax tendon, we went for LR muscle recession and Y-splitting alongwith transposition of nasal half of SR tendon 0.5 mm superior to MR. Postoperatively, eye was orthotropic with complete abduction and significant improvement in adduction and downshoot. In exo-DRS with downshoot in adduction, usually the LR muscle is tight. However, in our case it was lax. Despite, we went for LR recession and obtained satisfactory results. Hypoplastic changes in the LR muscle have been described previously and hence downshoot on attempted adduction may be d/t primary innervational anamoly. Therefore, a lax LR tendon should not change surgical plan in cases with shoots on adduction