The aim of the study was to identify factors associated with surgical outcomes in isolated abducens palsy. To achieve this goal the authors reviewed the records of adult patients with abducens palsy who underwent strabismus procedures during a fourteen year period. Outcome measures included motor alignment, extraocular motility and sensory outcome. A successful outcome was defined for the purpose of this study as absence of diplopia without prisms or face turn, vertical deviation ≤2 prism dioptres (PD) and horizontal deviation ≤10PD. There were 81 patients included in the study and 58% achieved a successful outcome. Success rates varied dependent on the aetiology of the abducens palsy and patients with an underlying neoplastic or traumatic aetiology required more than one strabismus surgery procedure more often (compared with microvascular / idiopathic or other central nervous system causes). For complete abducens palsies, patients undergoing Hummelsheim type procedures had a higher success rate than those who underwent a full tendon vertical rectus muscle transposition. Overall, success rates for strabismus procedures are similar in patients across all aetiologies considered. Although this study has limitations with its retrospective design based on historical data, the information collected from a significant number of patients can provide valuable assistance when deciding on surgical invention options for patients with abducens palsy. 

Functional and motor outcomes of strabismus surgery for chronic isolated adult sixth nerve palsy.
Peragallo JH, Bruce BB, Hutchinson AK, et al.
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Claire Howard

Salford Royal NHS Foundation Trust, Salford, UK.

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