Purpose: In the present study we assessed the vertical effect of horizontal muscle transposition when performing a resection-recession procedure on a patients with moderate vertical deviation along with horizontal deviation with some additional displacement of horizontal recti i.e. 3/4th instead of 1/2 width displacement. Material and Method: Present study was carried out in a series of 20 cases in the age group 3-40 years of both sexes with complicated squint having both horizontal and vertical deviation of varying amount with special emphasis on sensory status. Cases were broadly divided into two groups- Group 1(12 cases): Patients with Exotropia (40-50PD) and Hypertropia of <12 PD. Group 2(8 cases): Patients with exotropia(40-50PD) and Hypertropia of 12-20 PD. Results: Postoperative vertical deviation corrections are graded as- Very Good :- < 2-4PD. Moderate: - 4-8PD, Fair: - 10-16 PD. In group 1-8 cases (66%) out of 12 results were very good; Rest 4 cases (34%) results were moderate. In group 2- 6 cases (75%) out of 8 results were very good; Rest 2 cases (25%) results were moderate. Conclusion: Vertical muscle displacement is a very good option for correction of moderate vertical deviation especially for ophthalmic surgeons not experienced in tackling oblique muscles. Present study suggests that 3/4th width muscle displacement was more effective than 1/2th width muscle displacement.

Keywords: Squint surgery; Strabismus Surgery;Hypertropia; Exotropia