Surgical Correction of Exotropia due to Oculomotor Nerve Palsy

In third nerve palsy, the functions in the four of the six extraocular muscles are compromised and its treatment is the most difficult problem in the paralytic strabismus. In surgical method, large recession and resection of horizontal rectus muscles, lateral rectus muscle transposition to medial rectus muscle and superior oblique muscle transposition are used for strabismus surgery on oculomotor nerve palsied eye. We compared the results of two methods of surgical correction. In three eyes, lateral muscle transpositions to medial rectus muscle were performed. On the last follow up examination (men; 6.7 months), two eyes resulted in severe hypertropia and unacceptable ocular alignment and no improvement of limited adduction. In six eyes of whom superior oblique muscle transpositions were performed, all resulted in acceptable ocular alignment, no hypertropia, and the limitations of adduction were improved markedly. Therefore, in the treatment of third nerve palsy, sperior oblique muscle transposition is more effective than lareral rectus muscle transposition to medial rectus muscle.

Strabismus Surgery on Congenital Oculomotor Nerve Palsied Eye

In congenital third nerve palsy, the function in four of the six extraocular muscles is compromised, and its treatment is the most difficult problem in paralytic strabismus. In general, either large recession and resection on horizontal rectus muscles or superior oblique muscle transposition is used for treatment. We compared the results of the two methods of surgical therapy. A Total of nine eyes in nine cases underwent surgical correction for ocular alignment in the primary position, In four eyes of four cases horizontal rectus muscle surgery was performed. In five eyes of five cases superior oblique muscle transposition was performed. Postoperatively, one of four cases who underwent horizontal rectus muscle surgery and four of five cases who underwent superior obique muscle transposition resulted in acceptable ocular alignment, in which the angle of deviation at the primary position was within 2 delta. Therefore, in the treatment of congenital third nerve palsy, superior oblique muscle transposition is more effective than horizontal rectus muscle surgery for the correction of ocular alignment.