Results of extraocular muscle surgery in WEBINO bilateral internuclear ophthalmoplegia patients

PurposeTo evaluate the results of extraocular surgery in patients with large exotropias from “wall-eyed” bilateral internuclear ophthalmoplegia (WEBINO).MethodsEight patients with WEBINO evaluated between November 1994 and October 2006 underwent extraocular muscle surgery. Three patients required a second procedure.ResultsAn 85% reduction in exodeviation occurred postoperatively. Fusion responses were demonstrable in 87.5% of patients. Other ocular signs of internuclear ophthalmoplegia (INO) such as adduction limitation, abducting nystagmus, and ocular dysmetria also improved. These results were obtained following two-staged unilateral recession-resection procedures in seven patients; the remaining patient underwent bilateral lateral rectus recessions.ConclusionsBinocular outcomes are achievable in patients with WEBINO following extraocular muscle surgery, and associated ocular signs may be reduced or eliminated.