Abstract: Objective · To investigate the clinical effect of partial transposition of the vertical rectus combined with medial rectus recession on the treatment of abducens nerve palsy esotropia under the microscope. Methods · Nine patients with abducens nerve palsy esotropia were treated in Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine from March 2015 to June 2017. The strabismus surgery was performed under the microscope, with partial transposition of the vertical rectus combined with medial rectus recession. Postoperative follow-up was performed to observe the effect. Results · After 1 week, 7 patients’ primary position were orthotopic(within ±10Δ), and 2 patients were undercorrection (+15Δ and +20Δ). Abduction function of all the patients improved significantly. The eyes could cross the midline. After 1 month, 6 patients’ primary position were orthotopic (within ±10Δ), 3 patients were undercorrection(respectively +15Δ, +15Δ and + 30Δ). After 1 year, 5 patients’ primary position were almost orthotropia (within ±10Δ), and 4 patients were undercorrection (respectively +15Δ, +15Δ, +30Δ and +40Δ). Conclusion · Partial transposition of the vertical rectus combined with medial rectus recession under the microscope is a safe and effective surgical method in treatment of complete abducens nerve palsy esotropia. It can not only improve the ocular position, but also effectively improve the abduction function of the paralytic eye. However, it is easy to be undercorrection in the long-term.

Key words: abducent palsy, esotropia, transposition of vertical rectus, medial rectus recession