A muscle transposition procedure for abducens palsy, in which the halves of the vertical rectus muscle bellies are sutured onto the sclera.
OBJECTIVE
To review the results of a muscle transposition procedure in which the halves of the vertical rectus muscle bellies are sutured onto the sclera, without tenotomy of vertical recti as in Hummelsheim's procedure or surgical treatment of the lateral rectus (LR) as in Jensen's procedure.


METHODS
Ten patients with abducens palsy received the procedure. We measured the ocular deviation and the field of single binocular vision, and observed the LR using magnetic resonance imaging (MRI).


RESULTS
Preoperative or postoperative deviation was distributed from +27 to +58 prism diopters (PD) or orthophoria to +12 PD, respectively, in 7 patients with unilateral paresis, and +75 to +120 PD or +2 to +37 PD in 3 patients with bilateral paresis. The average correction was 42.4 PD per eye. Seven patients were able to regain the field of single binocular vision at least in the primary position. No postoperative complications were observed. MRI showed that the LR was atrophic and floppy, lacking muscle tension.


CONCLUSIONS
Our procedure enabled the patients to obtain satisfactory postoperative results without treatment of the LR or tenotomy of the transposed muscles. This procedure can reduce operative damage to the eye more than Hummelsheim's or Jensen's procedure.
Nishida
Yasuhiro
Y
Department of Ophthalmology, Shiga University of Medical Science, Seta, Tsukinowa, Otsu, Japan.
Inatomi
Akihiro
A
Aoki
Yoshiko
Y
Hayashi
Osamu
O
Iwami
Tatsuya
T
Oda
Sanae
S
Nakamura
Jiro
J
Kani
Kazutaka
K
D020434:Abducens Nerve Diseases / Q000175:diagnosis / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000473:pathology / Q000637:transplantation*; D013508:Ophthalmologic Surgical Procedures; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D015348:Vision, Binocular / Q000502:physiology