Temporalis Fascia for the Management of Medial Rectus Damage Secondary to Endoscopic Sinus Surgery: A Case Report

PURPOSE: To report a challenging case of medial rectus (MR) damage secondary to endoscopic sinus surgery (ESS). METHODS: A 37-year-old woman presented with diplopia, exotropia, and adduction deficit of the right eye due to the right MR injury secondary to the ESS. RESULTS: As a stepwise approach, she respectively underwent repairing of the damaged MR plus ipsilateral lateral rectus recession, half-tendon vertical rectus transposition to the MR insertion, and eventually nasal globe fixation with temporalis fascia that ultimately provided a single vision in the primary position with orthophoria. CONCLUSIONS: Re-establishment of an acceptable field of a single binocular vision in the context of iatrogenic MR injury is challenging and often requires multiple step-wise operations. Temporalis fascia is a safe and strong autogenous material, which can be used for globe fixation in this setting.