Outcomes of Treatment for Sixth Nerve Palsy

To report the outcomes of surgical and non-surgical treatment for sixth nerve palsy and paresis in our center. Hospital records of 33 patients (35 eyes) with sixth nerve dysfunction who were referred to Labbafinejad Medical Center from September 1996 to September 2006 and underwent surgical procedures or botulinum toxin injection were reviewed. Patients were divided into three groups: Group A had muscle surgery without transposition; group B had transposition procedures and group C had botulinum toxin injection. The deviation improved from 50.3±16.8 to 6±9.8 prism diopter (PD) after the first operation and to 2.5±5 PD after the second operation in group A; from 56.9± 24.3 to 5.5±16 PD after the first operation and to almost zero following the second operation in group B; and from 44.3±10.5 to 15±20 PD 6 months following botulinum toxin injection. Head posture and limitations of motility also improved significantly in all three groups. The overall reoperation rate was 18.2%. Various procedures are effective for sixth nerve dysfunction; all improve ocular deviation, head turn and abductive capacity of the eye. The rate of reoperation is not high if treatment is selected appro-priately according to the patient's condition.