Fascia lata augmented nasal transposition of split lateral rectus in complete oculomotor nerve palsy with a previous failed surgery

Eur J Ophthalmol. 2020 May;30(3):608-611. doi: 10.1177/1120672119871456. Epub 2019 Aug 21.

Abstract

Purpose: To report our experience in the management of a complete oculomotor nerve palsy with a previous failed surgery.

Methods: We used a fascia lata augmented nasal transposition of the split lateral rectus in a patient who had complete oculomotor nerve palsy with recurrent exotropia after previous recession-resection surgery. The lateral rectus muscle was split in half, and then joined end-to-end with fascia strips with a 5-0 polyester nonabsorbable suture. The superior and inferior fascia strips were transposed to the adjacent of the superior and inferior corners of the insertion of medial rectus. With the globe being adducted about 10 degrees, the strips were sutured on the globe using fixed 5-0 polyester sutures.

Results: The patient showed orthotropic alignment at the primary position at the 5-month post-operation follow-up.

Conclusion: With adequate preoperative imaging-aided evaluation and meticulous intraoperative exploration, fascia lata augmented nasal transposition of split lateral rectus could be an option of treatment for complete oculomotor nerve palsy after a previous failed surgery.

Keywords: Complete oculomotor palsy; fascia lata; muscle transposition; reoperation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Exotropia / surgery*
  • Fascia Lata / transplantation*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Oculomotor Muscles / transplantation*
  • Oculomotor Nerve Diseases / diagnostic imaging
  • Oculomotor Nerve Diseases / surgery*
  • Postoperative Period
  • Reoperation
  • Suture Techniques
  • Treatment Failure