In 138 cases of paralytic exotropia due to oculomotor palsy, transposi
tion of the superior oblique muscle and resection of the medial rectus
muscle were carried out. Surgery was performed with or without recess
ion of the lateral rectus muscle. The long-term prognosis for 4 years
or more was observed in 35 cases. We found that the same results could
be obtained by selecting transposition of the superior oblique muscle
in cases of complete palsy and resection of the medical rectus muscle
in cases of incomplete palsy. There was no benefit in combining resec
tion of the medial rectus muscle when performing the transposition of
the superior oblique muscle. Regardless of which method was used, a co
mbination with recession of the lateral rectus muscle greatly improved
the effectiveness of the procedure.