Surgical Results of a Muscle Transposition Procedure for Abducens Palsy Without Tenotomy and Muscle Splitting

Muraki and associates deserve appreciation for describing a new procedure in the article Surgical Results of a Muscle Transposition Procedure for Abducens Palsy Without Tenotomy and Muscle Splitting. However, the success they claim regarding improvement in range of movements requires further deliberation. Considering Figure 3, in which comparison has been made between pre- and postoperative results, adduction of the left eye in right gaze is less in preoperative than in postoperative eyes. In fact, preoperatively, both eyes are in dextrodepression position instead of true right gaze in a horizontal line, which has induced a narrowing of the palpebral fissure in both eyes preoperatively as compared to postoperatively. Thus, preoperatively, less forceful movement of both eyes in right gaze has resulted in an abduction deficit in the right eye, which has been claimed to improve postoperatively.