Superior rectus transposition versus medial rectus recession for esotropic Duane retraction syndrome (DRS)

2014 ◽  
Vol 18 (4) ◽  
pp. e18
Author(s):  
Ramesh Kekunnaya ◽  
Shailja Tibrewala ◽  
Virender Sachdeva
Keyword(s):  
Medial Rectus ◽  
Superior Rectus ◽  
Retraction Syndrome ◽  
Duane Retraction Syndrome

Reoperation in esotropic Duane retraction syndrome: Long-term motor outcome of superior rectus transposition

2019 ◽  
pp. 112067211989788
Author(s):  
Adriano Magli ◽  
Luca Rombetto ◽  
Paolo Esposito Veneruso
Keyword(s):  
Head Position ◽  
Medial Rectus ◽  
Head Turn ◽  
Superior Rectus ◽  
Vertical Deviation ◽  
Retraction Syndrome ◽  
Motor Outcome ◽  
Duane Retraction Syndrome

Aim: The aim was to evaluate the long-term motor outcome of superior rectus transposition procedure in patients affected by unilateral esotropic Duane retraction syndrome with residual esotropia and anomalous head position. Methods: A retrospective analysis of medical records of patients affected by esotropic Duane retraction syndrome who underwent superior rectus transposition procedure as reoperation for residual esotropia and/or residual anomalous head position. Amount of deviation, anomalous head position, duction limitation, globe retraction, presence of upshoot/downshoot, and vertical deviation were analyzed before and after superior rectus transposition procedure. Results: Twenty patients were selected. All patients underwent unilateral medial rectus recession or bilateral medial rectus recession, for unilateral esotropic Duane retraction syndrome at least 2 years before superior rectus transposition reoperation. Mean age at surgery (superior rectus transposition) was 12 ± 6.8 years, and the follow-up period was 2.7 ± 0.6. Mean deviations at distance and near before surgery were 19.5 ± 5.7 and 15.2 ± 6.8, respectively. Two patients showed upshoot. Head turn was 11.4 ± 5.1°; abduction limitation was −2.6 ± 0.9. After superior rectus transposition, all patients showed an improvement of esotropia at distance and near (8.1 ± 5.7 and 5.1 ± 5.6, respectively; p < 0.05), anomalous head position (5.6 ± 3.9°; p < 0.05), and abduction limitation (−2.3 ± 0.8; p < 0.05). No statistically significant changes occurred in globe retraction. No adduction limitation, vertical deviation, and upshoot/downshoot were present after superior rectus transposition procedure. Results were stable during follow-up. Conclusion: Superior rectus transposition procedure is an effective procedure in esotropic Duane retraction syndrome patients who previously undergone unilateral/bilateral medial rectus recession, with residual esotropia and anomalous head position. It allows improvement of esotropia, head turn, and partial recovery of abduction in a significant percentage of patients (30%) with no vertical complications.

scholarly journals Results of asymmetric bilateral medial rectus retroposition in unilateral Duane retraction syndrome’s type I

2012 ◽  
Vol 59 (3) ◽  
pp. 77-80
Author(s):  
Milorad Ljutica ◽  
Miroslav Stamenkovic ◽  
Dusica Risovic ◽  
Nebojsa Nikitovic ◽  
Branko Stankov
Keyword(s):  
Anterior Segment ◽  
Medial Rectus ◽  
Type I ◽  
Refractive Errors ◽  
Pathological Changes ◽  
Retraction Syndrome ◽  
Before And After ◽  
Duane Retraction Syndrome ◽  
The Right

Objective: To describe the results of asymmetric bilateral medial rectus retroposition in unilateral Duane retraction syndrome-this type I. Method: This is a retrospective study involving 18 patients, mean age 11.2 years (3-37 years) with unilateral Duane retraction syndrome?s type who were operated in 2009 up to 2011 year. The aim was to investigate the existence of ocular torticollis, size deviation before and after surgery and presence of amblyopia, anisometropia, type of refractive errors and lateralization. Results: All 18 patients were surgically treated by asymmetric retroposition of internal rectus (for 1-2mm more on the healthy eye). All patients preoperatively de-monstrated ocular torticollis. Size of mean preoperative deviation was +22.2 pD of primary angle PD and +46 pD of secondary angle. Postoperative finding: deviation of> +10 PD is noted to the presence of mild torticollis in one patient. Intermediate follow-up period was 9.8 months. Unilateral Duane?s syndrome is common among members of women (67%) compared to males (33%). Lateralization of Duane?s syndrome is more common in the left eye compared to the right (83% vs. 17%). Amblyopia was present in two patients and anisometropia (11.1%). As for refractive errors: hyperopia was found in 9 patients (50%), hypermetric astigmatism in 7 cases (39%), myopia and 1 (5.5%) and emmetropia (5.5%). None of the patients had no pathological changes in the fundus and anterior segment. Conclusion: Asymmetric bilateral medial rectus retroposition is extremely effective in the treatment of ocular torticollis and esotropia in patients with unilateral Duane retraction syndrome-this type I.

Hummelsheim procedure combined with medial rectus recession in complete sixth nerve palsy and esotropic Duane Retraction Syndrome

2020 ◽  
pp. 112067212097361
Author(s):  
Abbas Bagheri ◽  
Amirreza Veisi ◽  
Mehdi Tavakoli
Keyword(s):  
Nerve Palsy ◽  
Botulinum Toxin Injection ◽  
Rectus Muscle ◽  
Strabismus Surgery ◽  
Medial Rectus ◽  
Prism Diopter ◽  
Sixth Nerve Palsy ◽  
Retraction Syndrome ◽  
Duane Retraction Syndrome ◽  
Sixth Nerve

Purpose: To evaluate the effect of half tendon vertical rectus muscle transposition (HVRT) combined with medial rectus muscle recession (MRrec) in complete sixth nerve palsy (CSNP) and esotropic Duane Retraction Syndrome (eDRS). Methods: A retrospective study of patients with unilateral CSNP or eDRS who underwent HVRT combined with medial rectus recession over the course of 18 years. The patients with previous strabismus surgery and follow up less than 3 months were excluded. Overcorrection was defined as any amount of exotropia, and undercorrection was defined as residual esotropia of ⩾10 prism diopter (PD). Results: A total of 39 patients were enrolled including 22 CSNP and 17 eDRS patients. Esotropia improved from 45.8 ± 22 and 22.5 ± 6.4 PD to 0.8 ± 2.5 and 0.3 ± 1 PD in CSNP group and eDRS group respectively. The angle of face turn improved from 34.3 ± 8.4° and 26.5 ± 9° to 0.6 ± 2.4° and 0.8 ± 1.6° in the CSNP group and eDRS group respectively. Abduction limitation improved from −4.5 ± 0.5 and −4 ± 0 units to −2.9 ± 0.5 and −2.7 ± 0.5 units in CSNP group and eDRS group respectively. No patient developed a new vertical deviation. An overcorrection occurred in one patient of the eDRS group who improved after botulinum toxin injection in the ipsilateral lateral rectus muscle. Undercorrection was seen in two patients. Conclusion: HVRT combined with MRrec is an effective procedure to improve esotropia, face turn, and abduction limitation in CSNP and eDRS.

Modified Y Splitting of Lateral Rectus in Treatment of Abnormal Vertical Eye Movements Combined with Globe Retraction in Duane Retraction Syndrome

2020 ◽  
pp. 1-3
Author(s):  
Ayse Gul Kocak Altintas ◽  
Ayse Gul Kocak Altintas
Keyword(s):  
Case Report ◽  
Eye Movements ◽  
Palpebral Fissure ◽  
Ocular Motility ◽  
Severe Restriction ◽  
Horizontal Movement ◽  
Retraction Syndrome ◽  
Duane Retraction Syndrome ◽  
Ocular Motility Disorders

Duane retraction syndrome is the most frequently seen restrictive ocular motility disorders. It is clinically presented with limitation of horizontal movement, variable amounts of upshoots or downshoots and globe retraction combined with narrowing of the palpebral aperture on attempted adduction. An 8-year-old patient presented with severe restriction of abduction, reciprocal upshots or downshoots, and globe retraction combined with the palpebral fissure narrowing of on adduction. After the modified Y splitting of LR and recession of both horizontal rectus operation, all cosmetically disfiguring clinical features disappeared. In this case report modified Y splitting procedure and its long-term efficacy is presented.

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