The authors evaluated the outcomes of a surgical procedure involving the muscle union of the superior rectus and lateral rectus muscles with and without medial rectus recession and the anatomic changes before and after surgery in 35 eyes of 20 patients. Surgery included the union of muscle bellies with suture 14-15mm posterior to the muscle insertions. Muscles were not split and were not attached to the sclera. Mean age at strabismus onset was 34.8 years ±3.1. Fifteen had bilateral high axial myopia and five were unilateral. Axial lengths were 26-36mm (mean 30.6±2.8). Mean refraction was -19.01±3.1D. Significant improvement was found in which the angle remained stable over four years follow-up. Nine eyes were cured with superior rectus / lateral rectus surgery alone. Indication for medial rectus recession was presence of positive forced duction test and tight medial rectus and the time of surgery. Mean preoperative angle of globe dislocation of 178 degrees which reduced to 101 degrees. Horizontal angle decreased from 58.6 to 6.8PD and vertical angle decreased from 12.5 to 3.3PD. Ocular movements were significantly increased postoperatively. The authors concluded this to be an effective procedure.