Strabismus Surgery on Congenital Oculomotor Nerve Palsied Eye

ABSTRACT

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.