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Year : 2021  |  Volume : 1  |  Issue : 2  |  Page : 365-367

Overcorrection after modified Nishida's procedure and medial rectus recession for sixth nerve palsy reversed by cutting one transposition suture

Department of Strabismus and Pediatric Ophthalmology, The Eye Foundation, Coimbatore, Tamil Nadu, India

Correspondence Address:
Dr. Muralidhar Rajamani
Department of Strabismus and Pediatric Ophthalmology, The Eye Foundation, 582A, D.B. Road, R.S. Puram, Coimbatore - 641 002, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_2433_20

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A number of vertical rectus transposition procedures have been described for nonresolving complete sixth nerve palsy. Overcorrections following transposition procedures may be treated by reversing/adjusting the transposition or advancing the medial rectus (if previously recessed). Undercorrections require transposing an additional vertical rectus or recessing the medial rectus. Of the many available transposition procedures for sixth nerve palsy, Nishida's procedure offers the advantage of not having to disinsert the vertical recti and sparing the ciliary circulation. There are no reports on management of overcorrections following this procedure to the best of our knowledge. We report a patient with complete sixth nerve palsy, who developed a consecutive exotropia and anterior segment ischemia after Nishida's transposition with medial rectus recession. He was successfully treated by cutting the transposition suture on superior rectus.

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