Variation of the modified Nishida procedure for traumatic rupture of inferior rectus muscle.

We present a case of traumatic rupture of the inferior rectus muscle associated with an inferior orbital floor fracture. Initial examination revealed a left hypertropia with severe limitation of infraduction of the left eye past the midline. The inferior rectus muscle could not be retrieved after an anterior orbitotomy. The patient underwent a variation of the modified Nishida procedure 3 months later. At 3 months' follow-up, he had a moderate undercorrection at distance and near and a mild improvement in infraduction. He was able to fuse with prism in his glasses. Traumatic rupture of the inferior rectus muscle is an uncommon and difficult problem to treat; the variation of the modified Nishida procedure presented here offered a feasible surgical option in this case.