The authors evaluated in a retrospective study the results of surgery in 28 patients with paralysis of the VIth cranial nerve. The standard surgical procedure which was selected as primary achieved orhtophoria in 21 patients. In 7 patients with persisting esotropia and diplopia transposition of the oculomotor nerves according to Hummelshein was indicated. After stabilization of the postoperative finding in all patients parallel position of the eyes and a improved compensatory position of the head was found. Markedly restored motility in abduction was observed only in patient. The method of first choice in treatment of paralysis of the sixth nerve but also of other oculomotor nerves are standard surgical procedures. By retroposition and resection of oculomotor muscles usually a satisfactory state in the primary position is achieved. Transposition operations are rather useful as supplementary operations in previously operated eyes. Indicattions are persisting diplopia and esotropia. Postoperative results as regards the primary position of the eyes are satisfactory but usually marked improvement of the motility cannot be foreseen.

        Key words: Paralysis of the VIth cranial nerve, retroposition and resection of oculomotor muscles, ischaemia of the anterior segment, transposition surgery, Botulotoxin A