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J AAPOS. 2009 Dec;13(6):578-82. doi: 10.1016/j.jaapos.2009.11.003.

Precaruncular approach for medial orbital wall periosteal anchoring of the globe in oculomotor nerve palsy.

Author information

1
Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. rohitsaxena80@yahoo.com

Abstract

PURPOSE:

To evaluate a precaruncular approach for fixation of the globe to the medial orbital wall periosteum for management of complete third (oculomotor) nerve palsy.

METHODS:

Consecutive patients with severe unilateral oculomotor nerve palsy present for at least 2 years were prospectively treated and evaluated. In all patients, a 12-16 mm recession of the lateral rectus muscle was performed along with the precaruncular anchoring procedure. Follow-up evaluations were performed at 1 week, and at 1, 2, and 3 months after surgery, with ongoing follow-up at 3 month intervals.

RESULTS:

Fourteen eyes of 14 patients with complete oculomotor nerve palsy were included in the series. The median horizontal preoperative deviation of -90(Delta) +/- 4.8(Delta) reduced to -10(Delta) +/- 8.3(Delta). The vertical deviation reduced from 24(Delta) +/- 7.4(Delta) to 12.8(Delta) +/- 6.0(Delta). Mean follow-up was 8.9 +/- 5.5 months (range, 6-21 months). A slight exotropic drift was observed over 4 to 6 weeks following surgery in all cases. Satisfactory alignment was observed in 13 of the 14 cases (92.85%) over the duration of the follow-up period.

CONCLUSIONS:

Anchoring the globe to the medial orbital wall using a precaruncular approach is a viable option in the management of complete external oculomotor nerve palsy.

PMID:
20006821
DOI:
10.1016/j.jaapos.2009.11.003
[Indexed for MEDLINE]

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