The surgical innervational effect: utilizing it to treat monocular elevation deficiency strabismus

Horta-Barbosa proposed, in 1978, what he named "innervational surgery" which means the weakening of a muscle of the sound eye in order to increase the innervation to its paretic yoke muscle. He proposed it for the paralysis of the third cranial nerve in which the medial rectus has some residual force. The method can be accomplished also by means of prisms, like Guibor's method for lateral rectus paresis or botulinum toxin.

To present 5 cases of oculomotor muscle paresis with monocular elevation deficiency in which the 'innervation surgery' was used and to discuss its indications and results.

Five cases, a third nerve paresis and four idiopathic monocular elevation deficiency are presented with their indications, kind of surgery, results and comments.

The authors conclude that in moderate cases of monocular elevation deficiency, using this simple and easier operation one can achieve a good restoration of normal appearance.