Partial third cranial nerve palsy

Clinical characteristics and surgical management

Michael Flanders, Jesia Hasan, Abdullah Al-Mujaini

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose: Incomplete recovery from injury to the third cranial nerve results in ocular misalignment and associated diplopia. Our aim in this study was to describe and evaluate strabismus surgery strategies aimed at restoring functional, single binocular vision in this population. Design: Retrospective review. Participants: We studied 12 adult patients with acquired partial third cranial nerve palsy who underwent strabismus surgery. Methods: The 12 consecutive patients with residual third nerve palsy were selected from among the patients seen between 2000 and 2010 in the clinical practice of 1 strabismologist (M.F.). Complete pre- and postoperative ophthalmologic and orthoptic examinations were performed in each patient. The patients presented with isolated hypotropias (n = 7) and exohypotropias (n = 5). Strabismus surgery included: contralateral superior rectus recession, ipsilateral inferior rectus recession, vertical transposition of horizontal recti, horizontal rectus muscle surgery, or combined horizontal and vertical muscle surgery. Complete surgical success was defined as postoperative alignment within 5 prism diopters (PD) of orthotropia and the absence of diplopia in functional positions of gaze. The average follow-up was 23 months (range, 7 to 81 months). Results: The mean preoperative vertical and horizontal deviations were 19 PD hypotropia (8-40 PD) and 19 PD exotropia (6-40 PD), respectively. The mean postoperative deviations were 2 PD hypotropia (0-8 PD) and 1 PD exotropia (0-6 PD). Complete surgical success was achieved in 7 of 12 patients. Partial success was attained in 5 of 12 patients, who experienced significant improvement but required postoperative use of a prism. Conclusions: This study indicates that patients with incomplete third cranial nerve paralysis may enjoy good functional and cosmetic outcomes with strabismus surgery.

Original languageEnglish
Pages (from-to)321-325
Number of pages5
JournalCanadian Journal of Ophthalmology
Volume47
Issue number3
DOIs
Publication statusPublished - 2012

Fingerprint

Oculomotor Nerve Diseases
Oculomotor Nerve
Cranial Nerve Diseases
Strabismus
Exotropia
Diplopia
Oculomotor Nerve Injuries
Orthoptics
Binocular Vision
Muscles
Cosmetics

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Partial third cranial nerve palsy : Clinical characteristics and surgical management. / Flanders, Michael; Hasan, Jesia; Al-Mujaini, Abdullah.

In: Canadian Journal of Ophthalmology, Vol. 47, No. 3, 2012, p. 321-325.

Research output: Contribution to journalArticle

@article{b7c07868820d477db35010ad6aa8adfd,
title = "Partial third cranial nerve palsy: Clinical characteristics and surgical management",
abstract = "Purpose: Incomplete recovery from injury to the third cranial nerve results in ocular misalignment and associated diplopia. Our aim in this study was to describe and evaluate strabismus surgery strategies aimed at restoring functional, single binocular vision in this population. Design: Retrospective review. Participants: We studied 12 adult patients with acquired partial third cranial nerve palsy who underwent strabismus surgery. Methods: The 12 consecutive patients with residual third nerve palsy were selected from among the patients seen between 2000 and 2010 in the clinical practice of 1 strabismologist (M.F.). Complete pre- and postoperative ophthalmologic and orthoptic examinations were performed in each patient. The patients presented with isolated hypotropias (n = 7) and exohypotropias (n = 5). Strabismus surgery included: contralateral superior rectus recession, ipsilateral inferior rectus recession, vertical transposition of horizontal recti, horizontal rectus muscle surgery, or combined horizontal and vertical muscle surgery. Complete surgical success was defined as postoperative alignment within 5 prism diopters (PD) of orthotropia and the absence of diplopia in functional positions of gaze. The average follow-up was 23 months (range, 7 to 81 months). Results: The mean preoperative vertical and horizontal deviations were 19 PD hypotropia (8-40 PD) and 19 PD exotropia (6-40 PD), respectively. The mean postoperative deviations were 2 PD hypotropia (0-8 PD) and 1 PD exotropia (0-6 PD). Complete surgical success was achieved in 7 of 12 patients. Partial success was attained in 5 of 12 patients, who experienced significant improvement but required postoperative use of a prism. Conclusions: This study indicates that patients with incomplete third cranial nerve paralysis may enjoy good functional and cosmetic outcomes with strabismus surgery.",
author = "Michael Flanders and Jesia Hasan and Abdullah Al-Mujaini",
year = "2012",
doi = "10.1016/j.jcjo.2012.03.030",
language = "English",
volume = "47",
pages = "321--325",
journal = "Canadian Journal of Ophthalmology",
issn = "0008-4182",
publisher = "Canadian Ophthalmological Society",
number = "3",

}

TY - JOUR

T1 - Partial third cranial nerve palsy

T2 - Clinical characteristics and surgical management

AU - Flanders, Michael

AU - Hasan, Jesia

AU - Al-Mujaini, Abdullah

PY - 2012

Y1 - 2012

N2 - Purpose: Incomplete recovery from injury to the third cranial nerve results in ocular misalignment and associated diplopia. Our aim in this study was to describe and evaluate strabismus surgery strategies aimed at restoring functional, single binocular vision in this population. Design: Retrospective review. Participants: We studied 12 adult patients with acquired partial third cranial nerve palsy who underwent strabismus surgery. Methods: The 12 consecutive patients with residual third nerve palsy were selected from among the patients seen between 2000 and 2010 in the clinical practice of 1 strabismologist (M.F.). Complete pre- and postoperative ophthalmologic and orthoptic examinations were performed in each patient. The patients presented with isolated hypotropias (n = 7) and exohypotropias (n = 5). Strabismus surgery included: contralateral superior rectus recession, ipsilateral inferior rectus recession, vertical transposition of horizontal recti, horizontal rectus muscle surgery, or combined horizontal and vertical muscle surgery. Complete surgical success was defined as postoperative alignment within 5 prism diopters (PD) of orthotropia and the absence of diplopia in functional positions of gaze. The average follow-up was 23 months (range, 7 to 81 months). Results: The mean preoperative vertical and horizontal deviations were 19 PD hypotropia (8-40 PD) and 19 PD exotropia (6-40 PD), respectively. The mean postoperative deviations were 2 PD hypotropia (0-8 PD) and 1 PD exotropia (0-6 PD). Complete surgical success was achieved in 7 of 12 patients. Partial success was attained in 5 of 12 patients, who experienced significant improvement but required postoperative use of a prism. Conclusions: This study indicates that patients with incomplete third cranial nerve paralysis may enjoy good functional and cosmetic outcomes with strabismus surgery.

AB - Purpose: Incomplete recovery from injury to the third cranial nerve results in ocular misalignment and associated diplopia. Our aim in this study was to describe and evaluate strabismus surgery strategies aimed at restoring functional, single binocular vision in this population. Design: Retrospective review. Participants: We studied 12 adult patients with acquired partial third cranial nerve palsy who underwent strabismus surgery. Methods: The 12 consecutive patients with residual third nerve palsy were selected from among the patients seen between 2000 and 2010 in the clinical practice of 1 strabismologist (M.F.). Complete pre- and postoperative ophthalmologic and orthoptic examinations were performed in each patient. The patients presented with isolated hypotropias (n = 7) and exohypotropias (n = 5). Strabismus surgery included: contralateral superior rectus recession, ipsilateral inferior rectus recession, vertical transposition of horizontal recti, horizontal rectus muscle surgery, or combined horizontal and vertical muscle surgery. Complete surgical success was defined as postoperative alignment within 5 prism diopters (PD) of orthotropia and the absence of diplopia in functional positions of gaze. The average follow-up was 23 months (range, 7 to 81 months). Results: The mean preoperative vertical and horizontal deviations were 19 PD hypotropia (8-40 PD) and 19 PD exotropia (6-40 PD), respectively. The mean postoperative deviations were 2 PD hypotropia (0-8 PD) and 1 PD exotropia (0-6 PD). Complete surgical success was achieved in 7 of 12 patients. Partial success was attained in 5 of 12 patients, who experienced significant improvement but required postoperative use of a prism. Conclusions: This study indicates that patients with incomplete third cranial nerve paralysis may enjoy good functional and cosmetic outcomes with strabismus surgery.

UR - http://www.scopus.com/inward/record.url?scp=84862294212&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84862294212&partnerID=8YFLogxK

U2 - 10.1016/j.jcjo.2012.03.030

DO - 10.1016/j.jcjo.2012.03.030

M3 - Article

VL - 47

SP - 321

EP - 325

JO - Canadian Journal of Ophthalmology

JF - Canadian Journal of Ophthalmology

SN - 0008-4182

IS - 3

ER -