Nishida procedure for VIcnp

1 August 2019 | Fiona Rowe (Prof) | EYE - Paediatrics, EYE - Strabismus

This study reports results in treatment of complete sixth nerve palsy (VIcnp) by modified Hummelscheim (Nishida’s) procedure; vertical muscle halves after splitting were secured with anchoring sutures to the sclera with anchoring of only the temporal muscle margins to the sclera without any tenectomy or muscle splitting. Ten patients had large angle esotropia and limited abduction of -4 or more. All were unilateral palsies. Mean age was 44.2±9.2 years; six males and four females. Duration from onset to surgery was 80.16 months. Muscle transposition was in addition to medial rectus recession of 5-6.5mm; 0.8 reducing to -2.7±Limited abduction was -4.8±0.5 postoperatively. The authors conclude it is as effective as a surgical option, is surgically simpler and more minimal with less damage to ocular fascia and is less time-consuming. A modified vertical muscle transposition for the treatment of large-angle esotropia due to sixth nerve palsy.