Surgical Technique for Palsy of Superior Division of Oculomotor Nerve

This report is a description of a new surgical technique for palsy of the superior division of the oculomotor nerve. A 52-year-old female who had previously been operated on for an intracranial tumor described ocular motility restriction. A complete ophthalmological examination revealed elevation deficiency of -4 and accompanying ptosis in the left eye. Botulinum toxin injection was administered, and recession of the inferior rectus muscle, and tucking of the superior rectus following union of the medial and lateral rectus muscles were performed. In our technique, no scleral suture was used during the union of muscles procedure. Postoperatively, elevation improved significantly and hypotropia was fully corrected. In addition to being as effective as the previously described Knapp procedure, our technique is safer and easier.