[Outcomes after medial rectus recession and lateral rectus plication for abducens nerve palsy: A retrospective study]

Abducens nerve palsy (ANP) is the most common oculomotor palsy. This study aimed to evaluate the efficacy of medial rectus recession with lateral rectus plication in patients with unilateral acquired ANP and to describe the etiologies of this condition.

Thirty-one patients were included in this retrospective single-center study conducted between 2000 and 2019 at the university research hospital in Tours. The following data were collected before and after surgery: diplopia, oculomotor deviations, ocular motility, and head posturing.

The mean age was 55.9±18.9 years and the mean postoperative follow-up was 11±4 months. Postoperatively, the patients had significant reduction in diplopia in primary position (P<0.001), in abduction of the affected eye (P<0.001) and in distance and near horizontal deviations (P<0.001). Abduction of the affected eye was significantly improved (P<0.001), but reduction in head posturing was insignificant (P=0.27). The etiologies were as follows: trauma (8 patients, 26%), neoplasm (6 patients, 16%), stroke-related (5 patients, 16%), compressive (5 patients, 16%), undetermined (5 patients, 16%) and inflammatory (2 patients, 6%).

Medial rectus recession with lateral rectus plication is an effective procedure in reducing diplopia and ocular deviation in unilateral acquired ANP and may be used as a first-line intervention regardless of the initial ocular motility limitation in abduction. The causes are mainly traumatic but remain undetermined in one case out of six.