Dr. Smita Kapoor

Abstract

Management of large angle sensory exotropia (>70 PD) is challenging. Supramaximal recessions and resections can lead to limitation in ductions, palpebral fissure changes and even enophthalmos. Operating on the seeing eye is usually not acceptable to the patient. Therefore for such cases spacers have been used in the past but there are chances of extrusion with this technique. We present a case series of 5 patients who underwent muscle transplantation for sensory exotropia. This video describes the technique in a 25 year old male who had a history of alkali burn in the right eye 20 years back. A modified krimsky test revealed an exotropia of 70 PD. He underwent transplantation of medial rectus to lateral rectus in the right eye. All the patients achieved good cosmetic correction with no limitation of ductions or incomitance. Stability was maintained for 1 year. Thus muscle transplantation is a good alternative surgery for achieving long term stability in large angle sensory exotropia.