Muscle union procedure with medial rectus recession for unilateral abducens palsy

Five patients underwent a muscle union procedure with medial rectus recession. The mean preoperative esotropia in the primary position was 51.0 ± 20.1 prism diopters [PD] (range: 20 to 75 PD). The mean follow-up period was 6.2 ± 2.1 months (range: 3 to 8 months). The mean decrease in esotropia in the primary position was 49.0 ± 18.0 PD (range: 18 PD to 63 PD). The mean postoperative angle in the primary position was 1.6 ± 5.9 PD esotropia (range: 2 PD exotropia to 12 PD esotropia). There was no change in vertical deviation. Satisfactory ocular alignment was achieved using the loop muscle union procedure with weakening of the antagonist muscle. This could be considered an option for a transposition procedures in patients with abducens palsy who have a large-angle esotropia or significant residual deviation after conventional surgery.