The authors present the results of transposition surgery without concomitant lateral rectus weakening in a retrospective review of five cases. Surgery was for large exotropia and marked limitation of adduction after surgical loss of the medial rectus muscle. Mean age was 20.4±7.45 years. Surgery involved full tendon vertical rectus muscle transposition with augmentation as the initial correcting procedure. Angle of deviation was a mean of 46.7±9.9PD reducing to 20.8±13.4PD which was significant. No vertical deviation was induced by surgery. Adduction improved by 7.5±3.8 degrees on average which was significant. No surgical complications were reported for this procedure and no restriction on forced duction test was produced.