Periosteal Fixation in Third-Nerve Palsy

Pradeep Sharma, Madhurjya Gogoi, Sachin Kedar, Rahul Bhola

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Purpose: We present a new technique of anchoring the eyeball to the nasal periosteum using a nonabsorbable suture in acquired isolated third-nerve paresis.Methods: This was a case series of 4 consecutive adult subjects with isolated third-nerve paresis. After a 12-mm lateral rectus muscle recession in all 4 subjects, we passed 5-O double-armed polyester (NW683 Ethibond; Ethicon, Division of Johnson and Johnson Ltd., Aurangabad, India) on spatulated needles through the periosteum overlying the anterior lacrimal crest (exposed as in a Dacryocystorhinostomy procedure) at its superior part. The needles were brought anterior to the medial rectus muscle insertion and tightened enough to align the eye in 8-10 prism diopters adducted position. Results: Ocular alignment in the primary gaze was satisfactory at 6-12 months of follow up. Conclusions: The use of a nonabsorbable polyester suture to anchor the globe to the nasal periosteum is an additional technique that holds promise to align the eyes in the primary gaze.

Original languageEnglish (US)
Pages (from-to)324-327
Number of pages4
JournalJournal of AAPOS
Issue number4
StatePublished - Aug 2006
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Ophthalmology


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