Abstract
Two patients with 90 prism diopters of exotropia and an absent medial rectus muscle each had the nasal half of the superior and inferior rectus muscles joined with a thin strip of preserved sclera. The center of the scleral strip was first anchored to host sclera at the usual site of the medial rectus insertion. Alignment was improved in the primary position with a residual exodeviation of 25 prism diopters and 20 prism diopters, respectively. Each patient required secondary conjunctival recession because of a delle.
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