Transposition surgery for the treatment of paralytic exotropia

Purpose: The purpose of this study was to evaluate the surgical and functional results of muscle transposition in patients with paralytic exotropia (XT) due to partial or complete 3rd nerve palsy or lost or injured medial rectus muscle (MR). Methods: The charts of 24 con-secutive patients undergone transposition surgery between 2000 and 2010 for paralytic XT were reviewed. Surgery consisted of vertical rectus muscles or superior oblique (SO) ten-don transposition to the paralyzed MR. Results: The horizontal deviation in primary posi-tion changed from 25-90 prism diopters (PD) of XT (mean: 55.5 PD) preoperatively to 0-20 PD of XT postoperatively (mean: -8 PD). Discussion: Transposition surgery seems to be a suitable procedure for the treatment of paralytic XT without any function of the MR. Depending on the presence or absence of vertical rectus muscles’ function, transposition of the vertical recti or the SO tendon respectively to the MR is the treatment of choice.