Combined recession-resection in the management of paralytic strabismus: simplification of the complex (a case report).

Pan Afr Med J

Department of Ophthalmology, Faculty of Medicine Airlangga University, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Published: December 2024

AI Article Synopsis

  • - Oculomotor nerve palsy poses significant treatment challenges for eye disorders, particularly causing paralytic exotropia, as seen in a 32-year-old male patient with severe squint due to partial nerve palsy.
  • - Traditional surgical techniques, like periosteal fixation with Callahan suture, may be too complex; this case suggests a simpler approach using medial rectus resection and lateral rectus recession can be effective.
  • - The patient underwent a successful eye surgery that improved his condition, showcasing that the combination of these surgical methods can lead to good outcomes and long-term stability in managing this type of strabismus.

Article Abstract

Oculomotor nerve palsy presents the greatest challenge in clinical treatment among the other cranial nerves that innervate extraocular muscle. With a complex technique of periosteal fixation using Callahan suture commonly used, a simpler and more effective technique is demanded to be proven. Here we present a case of paralytic exotropia due to oculomotor nerve palsy on a 32-year-old male along with evidence supporting our decision of surgical management. A 32-year-old male with a chief complaint of squint in both eyes was examined at an outpatient eye clinic. The patient had congenital isolated partial oculomotor nerve palsy and the examination revealed severe ptosis on both eyes with 40 prism diopter exotropia and no limitation in the forced duction test. The patient's posterior segment examination showed normal results, and a diagnosis of bilateral paralytic exotropia due to isolated partial oculomotor nerve palsy was considered. The patient underwent a 7.5 mm rectus lateral recession with a 6 mm rectus medial resection on his right eye, with a promising result after a 3-week follow-up. When treating paralytic strabismus resulting from isolated oculomotor nerve palsy, a combination of medial rectus resection and lateral rectus recession yields good results and long-term stability.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11614114PMC
http://dx.doi.org/10.11604/pamj.2024.48.165.44739DOI Listing

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