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Case Report
Double-under muscle transposition in long-standing sixth nerve palsy: A case report
1 Department of Ophthalmology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
2 Department of Ophthalmology, Rajavithi Hospital, Department of Medical Sciences, Ministry of Public Health, Bangkok, Thailand
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Withawat Sapthanakorn
Department of Ophthalmology, Faculty of Medicine, Thammasat University, Pathumthani,
Thailand
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Article ID: 100030Z17WS2022
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Sapthanakorn W, Thiamthat W, Thitiwichienlert S. Double-under muscle transposition in long-standing sixth nerve palsy: A case report. J Case Rep Images Opthalmol 2022;5(2):5–10.ABSTRACT
Introduction: To report a case of acquired esotropia after long-standing sixth nerve palsy with Double-under muscle transposition technique correction.
Case Report: A 41-year-old male presented with diplopia from an unruptured and thrombosed mid-basilar aneurysm that caused isolated left sixth nerve palsy for 18 months after undergoing surgery. He had left face turn, 66 prism diopters (PD) esotropia of the left eye, and a complete left abduction deficit. To improve a complete sixth nerve palsy, we performed a double-under muscle transposition (DUT) technique, vertical recti [superior and inferior (SR) and (IR)] were transposed under left lateral recuts (LR) muscle along with medical recuts (MR) recession. Following postoperative result at three months, he was found to be orthotropia at near and 8 PD of exotropia at distance. He also improved diplopia in the primary position and he could slightly abduct the left eye. He did not have any postoperative complication.
Conclusion: We demonstrated that a DUT technique can be a procedure of choice in patients with large angle deviation from paralytic strabismus.
Keywords: Diplopia, Double-under muscle transposition, Sixth nerve palsy
SUPPORTING INFORMATION
Author Contributions
Withawat Sapthanakorn - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Warakorn Thiamthat - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Suntaree Thitiwichienlert - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Withawat Sapthanakorn et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
