Back to Search
Start Over
Surgical strategy for third nerve palsy with aberrant regeneration: Harnessing the aberrant power
- Source :
- Indian Journal of Ophthalmology, Vol 69, Iss 4, Pp 910-917 (2021), Indian Journal of Ophthalmology
- Publication Year :
- 2021
- Publisher :
- Wolters Kluwer Medknow Publications, 2021.
-
Abstract
- Our study aimed to evaluate the outcome of contralateral eye (CE) fixation duress squint surgery (FDSS) in third nerve palsy (3rd NP) with aberrant regeneration and compare the postoperative ptosis correction with preoperative ptosis improvement on adduction. Methods: Patients of 3rd NP with aberrant regeneration who underwent CE FDSS between December 2012‑July 2015 in a tertiary‑care eye hospital with a follow‑up period of 1‑year were retrospectively studied to analyze preoperative and postoperative details. Surgical success was defined as the correction of ptosis within 1 mm of preoperative ptosis improvement during maximal adduction of the affected eye, postoperative alignment ≤10Δ, and resolution of subjective diplopia in primary position. Results: A total of 14 eyes in 14 patients (mean age 23.6 ± 13.6 years) were included. Mean preoperative exotropia and ptosis in primary position in 14 patients was 53.4 ± 20pd and 4.89 ± 2.9 mm, respectively, and mean hypotropia in 6 patients was 23.67 ± 5.89pd. The mean improvement of ptosis on adduction and supraduction in all patients was 4.07 ± 2.64 mm and 2.89 ± 2.22 mm, respectively (P = 0.213). All patients underwent large recession of CE lateral rectus (mean 12.4 ± 2.7 mm), 9 patients underwent CE medial rectus resection/plication (mean 6.0 ± 0.9 mm) and 6 patients underwent CE superior rectus recession (mean 6.6 ± 0.67 mm). Postoperatively, mean ptosis and exotropia correction was 3.7 ± 2.4 mm (P = 0.000) and 15 ± 9.6pd (P = 0.000), respectively, and mean hypotropia was 2.17 ± 4.02pd (P = 0.000). Surgical success was achieved in 6 patients. Postoperative ptosis correction showed strong positive correlation with preoperative improvement of ptosis on adduction (r = 0.87; P = 0.00). Conclusion: Preoperative lid excursion on adduction in 3rd NP can be regarded as a prognostic sign of the success of CE FDSS which can simultaneously correct both ptosis and squint.
- Subjects :
- Adult
medicine.medical_specialty
aberrant regeneration
Surgical strategy
Adolescent
genetic structures
Ophthalmologic Surgical Procedures
pseudo-graefe's sign
Nerve palsy
Positive correlation
pseudo-graefe‘s sign
Young Adult
Ptosis
third nerve palsy
lcsh:Ophthalmology
inverse-duane‘s sign
fixation duress
Oculomotor Nerve Diseases
medicine
Humans
Squint surgery
Child
Retrospective Studies
Fixation (histology)
Diplopia
Vision, Binocular
business.industry
medicine.disease
eye diseases
Surgery
Ophthalmology
Treatment Outcome
Oculomotor Muscles
lcsh:RE1-994
Exotropia
Original Article
inverse-duane's sign
medicine.symptom
business
Subjects
Details
- Language :
- English
- ISSN :
- 19983689 and 03014738
- Volume :
- 69
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Indian Journal of Ophthalmology
- Accession number :
- edsair.doi.dedup.....a891e19d0e447b3cd8e080606d115ff5