DOI: 10.36347/sjmcr.2019.v07i03.007

Pages: 193-195

A 78-year-old man presented with progressive esotropia of the left eye. He wears extremely thick eyeglasses (-12.75 diopter) because of high myopia, and the left eye was fixed in a position of extreme adduction, and ocular motility was severely restricted in all directions. Orbital magnetic resonance imaging demonstrated that the posterior portion of the elongated globe out from the muscle cone in the left eye. We performed surgery for muscle union of the superior rectus and lateral rectus muscles with recession of the medial rectus muscle. Postoperatively, esodeviation and adduction movement were improved. During surgery, it is considered that the most difficult procedure is suturing at a distance of 15 mm behind the superior rectus muscle insertion. In order to solve this problem, the initial traction suture at a distance 7 to 8 mm behind the superior rectus insertion might be effective.