Myectomy of lateral rectus muscle for third nerve palsy.

PURPOSE To introduce myectomy of the lateral rectus muscle for correcting exotropia in patients with third nerve palsy. METHODS The lateral rectus muscle of the paretic eye was myectomized without suturing it to the globe. This was combined with a medial rectus muscle resection and a contralateral lateral rectus muscle recession. Magnetic resonance imaging was performed to observe the re-attachment of the lateral rectus muscle to the globe. RESULTS The patient was able to fuse in the primary position without any noticeable limitation in abduction. Magnetic resonance imaging showed that the lateral rectus muscle was attached to the globe through fibrous tissue. CONCLUSION Myectomy of the lateral rectus muscle is an effective and simple procedure to accomplish a super-maximal weakening effect of abduction in patients with complete third nerve palsy.