Conjunctival resection and caruncular fixation for complete adduction palsy

Abstract

Correcting a large-angle exotropia (XT) secondary to a third cranial nerve (CNIII) palsy can be difficult. Supramaximal ipsilateral lateral rectus recession and medial rectus resection are often insufficient, and periosteal fixation procedures can be challenging. The purpose of this work is to describe the novel surgical technique of a large nasal conjunctival resection with caruncular fixation2, as an adjunct procedure to extraocular muscle surgery for the treatment of a large-angle XT secondary to CNIII palsy.