Incomitant vertical strabismus. Treatment with posterior fixation of the inferior rectus muscle.

Three patients with evidence of inferior rectus muscle paresis were surgically treated for diplopia in downgaze following blowout fracture of the orbit or operative trauma. In each case, surgery involved the placement of two posterior fixation sutures 13 or 14 mm behind the physiologic insertion of the inferior rectus muscle in the contralateral eye. In one case, posterior fixation was combined with a small inferior rectus muscle recession. All three patients experienced relief of their diplopia and improvement in their binocular field of vision. There were no untoward sequelae and no surgically induced changes in primary position alignment.