Temporal transposition of the inferior rectus muscle in a patient with incyclotropia

A 73-year-old man presented with torsional diplopia. With major amblyoscope he measured 10 degrees of incyclotropia in primary position and 20 degrees of incyclotropia in downgaze. The patient had undergone temporal transposition of the left inferior rectus muscle in order to reduce incyclotropia in downgaze. Postoperatively, incyclotropia was reduced to 8 degrees. However, he complained horizontal diplopia in lateral gaze. Therefore, the patient underwent the left lateral rectus muscle recession. Finally, the patient had no diplopia. Although temporal transposition of the inferior rectus muscle is an efficient method to correct for incyclotropia, we should be aware that this procedure might induce new horizontal and vertical deviation.