[Long term outcomes of chronic abducens palsy surgical treatment in children and adults].

Abducent nerve palsy is the most frequent of the acquired palsies and occurs rarely on congenital basis. It is widely recommened to wait at least 6 mohths for possible return of sixth nerve function. After this period we consider surgical management. Our retrospective comparative study evaluated long-term results of two methods for surgical treatment of chronic six nerve palsy in 118 pediatric and adult patiens who undergone surgery in the period from January 1990 to December 2005. Group A had 56 patients, in whom we performed a large recession of the medial rectus combined with a supramaximal resection of the lateral rectus. The Hummelsheim transposition procedure with or without resection of transposed half-tendon vertical muscle was performed in 62 patients of the B group. This procedure was always combined with recession of medial rectus. The augmented version of the transposition surgery resulted in a significantly better primary position of eyes postoperatively, than single graded recession-resection procedure of the horizontal muscles. The transposition surgery resulted in visible improvement in head posture and ocular alignment in the primary position, with partial restoration of abduction.