Dr.Sowmya R
To describe the efficacy of no split ,no tenotomy procedure (modified Nishida’s procedure) for monocular elevation deficiency in a twelve year old child .Modified Nishidas procedure is described for LR palsy and in esotropic DRS . This is the first report of the same procedure for MED .Seven year old child presented with drooping of left eyelid and squinting since birth. On examination,BCVA (OD 6/6,N6,(OS) 6/18, N8.(OS) ptosis. Primary gaze showing left hypotropia .elevation limitation of -4 (OS). Modified Nishida’s procedure was performed with IRrecession. Post opertaively child was orthophoric with improved elevation to -2.Modified Nishidas procedure is easy to perform and does not involve tenotomy or spilitting of the muscles .
The correction obtained with Modified Nishida’s was equivalent to Knapps procedure. In addition,it gives room for resurgery unlike routine transposition procedures
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