Surgery with Silicone Band for Sixth Nerve Paralysis

Kim, Jong Chan; Bae, Gye Jong

Abstract

When esotropia and diplopia is developed by Sixth nerve paralysis treatments including operation are delayed for 6 months; botulinum toxin injection to the medical rectus which is antagonist muscle, lateral rectus resection, medial rectus recession, transposition of the vertical recti to the horizontal plane and Jensen procedure. But there is little possibility of recovery of full rotation in the direction of action of the attacted muscle with classic recess-resect surgery. Transposition of the vertical recti to the horizontal plane has the problem that original actions of the transposed muscles are weakened, and vertical deviation may be introduced. We attampted the surgery with silicone band for the 42 year-old patient who was not improved sixth nerve paralysis for ten months for the purpose of regainning muscle force and reposioning esotropia. Silicone band was passed the medial half of superior and inferior rectus muscles and sutured beneath the lateral rectus muscle. We had the disappearance of diplopia and esotropia and improvement of lateral rectus muscle force from -4 to -2. We could predict that this method was good for sixth nerve paralysis.