Superior rectus belly transposition in a case of lost medial rectus muscle.

We present a case of exotropia secondary to a lost medial rectus muscle managed using a novel surgical approach, consisting of nasal belly transposition of the superior rectus muscle combined with lateral rectus recession on adjustable sutures. Postoperatively, the patient was orthotropic in primary position and had slight improvement in adduction. Compared to other techniques, this minimal transposition had a relatively low risk of anterior segment ischemia.