Consecutive patients with severe unilateral oculomotor nerve palsy present for at least 2 years were prospectively treated and evaluated. In all patients, a 12–16 mm recession of the lateral rectus muscle was performed along with the precaruncular anchoring procedure. Follow-up evaluations were performed at 1 week, and at 1, 2, and 3 months after surgery, with ongoing follow-up at 3 month intervals.
Fourteen eyes of 14 patients with complete oculomotor nerve palsy were included in the series. The median horizontal preoperative deviation of −90Δ ± 4.8Δ reduced to −10Δ ± 8.3Δ. The vertical deviation reduced from 24Δ ± 7.4Δ to 12.8Δ ± 6.0Δ. Mean follow-up was 8.9 ± 5.5 months (range, 6-21 months). A slight exotropic drift was observed over 4 to 6 weeks following surgery in all cases. Satisfactory alignment was observed in 13 of the 14 cases (92.85 % ) over the duration of the follow-up period.
Anchoring the globe to the medial orbital wall using a precaruncular approach is a viable option in the management of complete external oculomotor nerve palsy.