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Long Term Outcomes of Chronic Abducens Palsy Surgical Treatment in Children and Adults


Authors: K. Vodičková;  R. Autrata;  J. Řehůřek 1;  H. Ošlejšková 2
Authors‘ workplace: Dětská oční klinika LF MU a FN, Brno, přednosta doc. MUDr. R. Autrata, CSc., MBA 1;  Klinika dětské neurologie LF MU a FN, Brno, prim. MUDr. H. Ošlejšková, Ph. D. 2
Published in: Čes. a slov. Oftal., 64, 2008, No. 5, p. 197-201

Overview

Abducent nerve palsy is the most frequent of the acquired palsies and occurs rarely on congenital basis. It is widely recommened to wait at least 6 mohths for possible return of sixth nerve function. After this period we consider surgical management. Our retrospective comparative study evaluated long-term results of two methods for surgical treatment of chronic six nerve palsy in 118 pediatric and adult patiens who undergone surgery in the period from January 1990 to December 2005. Group A had 56 patients, in whom we performed a large recession of the medial rectus combined with a supramaximal resection of the lateral rectus. The Hummelsheim transposition procedure with or without resection of transposed half-tendon vertical muscle was performed in 62 patients of the B group. This procedure was always combined with recession of medial rectus. The augmented version of the transposition surgery resulted in a significantly better primary position of eyes postoperatively, than single graded recession-resection procedure of the horizontal muscles. The transposition surgery resulted in visible improvement in head posture and ocular alignment in the primary position, with partial restoration of abduction.

Key words:
strabismus surgery, chronic abducens palsy, Hummelsheim transposition procedure


Sources

1. Brooks, S.E., Olitsky, S.E., et al.: Augmented hummelsheim procedure for paralytic strabismus. JAAPOS, 37, 2000: 189-5.

2. Burke, J.P., Ruben, J.B., Scott, W.E.: Vertical transposition of the horizontal recti (Knapp procedure) for the treatment of double elevator palsy: effectiveness and long-term stability. Br. J. Ophthalmol., 76, 1992: 734-737.

3. Burke, J.P., Keech, R.V.: Effectiveness of inferior transposition of the horizontal rectus muscles for acquired inferior rectus paresis. JAAPOS, 32, 1995: 172-177.

4. Cline, R.A., Scott W.E.: Long-term follow-up of Jensen procedures. JAAPOS, 25, 1988: 264-269.

5. Foster, R.S.: Vertical muscle transposition augmented with lateral fixation. JAAPOS, 1,1997: 20-30.

6. Helveston, E.M.: Muscle transposition procedures. Surv. Ophthalmol., 16, 1971: 92-97.

7. Hiatt, R.L.: Transposition procedures in strabismus. Ann. Ophthalmol., 18, 1986: 332-336.

8. Holme, J.M., Leske, D.A. et al.: Initial treatment outcomes in chronic sixth nerve palsy. JAAPOS, 5, 2001: 370-376.

9. Maruo, T., Iwahige, H., et al.: Results of surgery for paralytic esotropia. Jpn. J. Ophthalmol., 40, 1996: 229-234.

10. Mc Manaway, J.W., Buckley, E.G., Brodsky, M.C.: Vertical rectus muscle transpostion with intraoperative botulinum injection for chronic sixth nerve palsy. Graefes Arch. Clin. Exp. Ophthalmol., 228, 1990: 401-406.

11. Paysse, E.A, Mc Creery, K.M.B, et al.: Use of augmented rectus muscle transposition surgery for complex strabismus. Ophthalmology, 109, 2002: 1309-1314.

12. Repka, M.X., Lam, G.C., Morrison, N.A.: The efficacy of botulinum neurotoxin A for the treatment of complete and partially recovered chronic sixth nerve palsy. JAAPOS, 31, 1994: 79-83.

13. Rosenbaum, A.L., Kushner, B.J., Kirschen, D.: Vertical rectus muscle transposition and botulinum toxin (Oculinum) to medial rectus for abducens palsy. Arch. Ophthalmol., 107,1989: 820-823.

14. Rosenbaum, A.L., Foster, R.S., et al.: Complete superior and inferior rectus transposition with adjustable medial rectus recession for abducens palsy. Strabismus, 2, 1984: 599-605.

15. Uribe, L.E.: Muscle transplantation in ocular paralysis. Am. J. Ophthalmol., 65, 1968: 601-607.

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