Augmented vertical rectus [corrected] transposition for the treatment of strabismus in Möbius syndrome

Abstract

Möbius syndrome is a rare congenital disorder characterized by bilateral facial nerve palsy and abducens nerve palsy. It is associated with a wide spectrum of systemic and ocular manifestations; esotropia is commonly the reason for ophthalmic referral. There are few published studies in the literature on strabismus surgery in Möbius syndrome. An augmented vertical rectus muscle transposition in which lateral fixation sutures are used on the transposed vertical rectus muscles (Foster augmentation) has been used to correct esotropia caused by severe sixth nerve palsy and type 1 Duane syndrome. We describe the surgical outcome after treating moderate- to large-angle esotropia in 3 patients with Möbius syndrome with the augmented vertical rectus muscle transposition.