Dr. REENA GUPTA

Dr.Preeti Yadav, Dr. NEEBHA ANAND, Dr. CHEKITAAN SINGH

Abstract

Oculomotor nerve palsy is a challenge to treat due to complex strabismus involving both horizontal &vertical muscles. Surgery is mainstay of treatment &various surgical procedures have been tried but none of them has been established to achieve stable alignment for long period of time. We present case series of complex strabismus post third nerve palsy managed surgically. A case of congenital 3rd nerve palsy managed by lateral periosteal fixation & medial rectus resection ,achieved cosmetically acceptable alignment which recurred after 6 months. Similarly, in another case of long standing idiopathic palsy ,two staged procedure -LR periosteal fixation with MR resection followed by MR periosteal fixation achieved optimal alignment which drifted outwards on follow up. A dissatisfied young male with congenital palsy who had undergone multiple procedures elsewhere , managed by nasal transposition of superior oblique ,which could not yield satisfactory alignment & also induced hypertropia.