We present a new procedure for treating inferior rectus weakness by means of lateral rectus belly transposition, without tenotomy or muscle splitting of the transposed muscle. In this technique, the lower margin of the lateral rectus belly is tied 8 mm posterior to the insertion then transposed to the sclera 2 mm temporal to and 8 mm posterior to the temporal pole of the inferior rectus muscle. We report 3 cases of inferior rectus underaction treated using this procedure. Postoperatively all 3 patients showed complete correction of vertical deviation in primary position and experienced greatly improved depression capacity, without newly induced horizontal or torsional deviation.
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