A Case of Nishida Muscle Transposition Procedure for Abducens Palsy.

Oh, In Seok; Jang, Ji Hye

doi:2015.56.8.1294

J Korean Ophthalmol Soc > Volume 56(8); 2015 > Article

Case Report

Journal of the Korean Ophthalmological Society 2015;56(8):1294-1299.
DOI: https://doi.org/10.3341/jkos.2015.56.8.1294 Published online August 15, 2015.

A Case of Nishida Muscle Transposition Procedure for Abducens Palsy.

In Seok Oh, Ji Hye Jang

Department of Ophthalmology, Daegu Fatima Hospital, Daegu, Korea. Mjmom99@naver.com

Nishida 근전위술을 시행한 외향신경마비 1예

오인석⋅장지혜

대구파티마병원 안과

Received: 19 December 2014 • Revised: 30 January 2015 • Accepted: 19 June 2015

Abstract

PURPOSE
Herein we report a successful Nishida muscle transposition procedure (modified Jensen procedure) with right medial rectus recession for treating a right abducens palsy patient. CASE SUMMARY: A 63-year-old male presented with a 30-year history of esotropia due to traumatic abducens palsy in his right eye. At initial examination, right eye visual acuity was 0.9 and intraocular pressure was 11 mm Hg. Ocular movement of the right eye was restricted in the lateral direction and prism cover-uncover test revealed 75 prism diopter right esotropia. For 2 years, the patient was treated as normal tension glaucoma and used his right eye as the dominant eye by turning his head due to glaucomatous field defect in the left eye. We performed 8.0 mm medial rectus recession and Nishida muscle transposition procedure in the right eye and inserted a suture through the temporal margin of each vertical rectus muscle. One week after surgery, the right eye maintained relatively straight alignment and prism cover-uncover test showed 20 prism diopter residual esotropia in the left eye. CONCLUSIONS: The Nishida muscle transposition is a simple procedure and prevents postoperative risk of anterior segment ischemia without the occurrence of tenotomy and muscle splitting. We report a successful Nishida muscle transposition procedure in a patient with chronic abducens palsy.

Key Words: Abducens palsy;Anterior segment ischemia;Muscle transposition;Nishida procedure