Management of large exotropia with medial rectus muscle transection following endoscopic sinus surgery

Objective To evaluate and compare the effect of surgeries in large exotropic patients who underwent a medial rectus muscle (MR) transection after endoscopic sinus surgery (ESS). Methods In 5 patients with exotropia (XT) and a lack of adduction after ESS, orbital CT revealed a complete transection of the midportion of the MR. 3 patients was treated within 3 months after injury. Foster procedure months after ESS with lateral rectus contraction. Surgery was divided into two stages. The adduction deficits were divided into - 1 through to - 8. The patients were followed up for more than than 6months. Results Postoperatively, 5 patients showed orthophoria or small exophoria within -5°among which 4 had no diplopia in the primary position, another one avoid diplopia by prism lens. The adduction deficits improved to -2 to -5. Conclusions Surgical management (vertical rectus muscle transposition) is effective in correcting a large exotropia secondary to a medial rectus transection after ESS. The best time for surgery is 3 months after injury. Key words: Endoscopiy ;  Otorhinolaryngologic surgical procedures ;  Postoperative complications ;  Oculomotor muscles ;  Exotropia ;  Ophthalmologic surgical ;