Esotropia caused by sixth cranial nerve palsy can greatly affect visual acuity, and if it doesn't improve within 6-10 months, surgery may be needed, with the modified Nishida procedure being a promising option for treatment without splitting muscles.
A 59-year-old woman with chronic complete sixth nerve palsy underwent the modified Nishida procedure combined with botulinum toxin A (BTA) injection after multiple unsuccessful surgeries, resulting in significant improvement in her condition.
Post-surgery, the patient experienced better eye alignment, less double vision, and a broader field of vision, showcasing the effectiveness of the modified Nishida procedure for this type of eye disorder.