Background. The majority of cases of exotropia with extreme deviations (30-
45 degrees or 60-90 prism dioptres) are secondary forms of strabismus, eith
er consecutive, following monolateral combined recession/resection procedur
es in childhood, extreme anisometropia or following trauma. For the surgica
l treatment the deviation is often too great to be corrected completely by
conventional repositioning of the medial and lateral rectus muscle of the a
ffected eye and patients justifiably refuse an operation even on the main e
ye because the indications are mostly more aesthetic than functional.
Methods. The paper presents a technique of a free mucosa transplant. The ef
fect can be strengthened and made more secure following repositioning of th
Results. With this method even extreme deviations (up to 45 degrees corresp
onding to 90 prism dioptres) could be successfully and permanently correcte
d by surgery on the deviated one eye only.
Conclusions. This method provides a new option for patients who are often i
ncorrectly told that their deviation cannot be corrected by monolateral sur