A rectus muscle union transferred muscle action without altering insertions on 11 eyes in nine patients with sixth nerve paralysis. Medial rectus tendon recession was also performed and is indicated for deviations greater than 25 prism diopters. The rectus muscle union tends to produce equal or superior cosmetic results and incidence of fusion, less vertical muscle imbalance, but a smaller amplitude of abduction than variations of Hummelsheim's technique. The rectus muscle union is recommended for the treatment of persistent sixth nerve palsies.
Frueh BR, Henderson JW. Rectus Muscle Union in Sixth Nerve Paralysis. Arch Ophthalmol. 1971;85(2):191–196. doi:10.1001/archopht.1971.00990050193013
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