scholarly journals Bilateral lateral rectus recession in exotropic Duane syndrome with downshoot

2016 ◽  
Vol 8 (1) ◽  
pp. 74-77 ◽  
Author(s):  
Chandra Maya Gurung ◽  
Suma Ganesh ◽  
Pawan Shrestha
Keyword(s):  
Lateral Rectus ◽  
Palpebral Fissure ◽  
Primary Position ◽  
Head Posture ◽  
Duane Syndrome ◽  
Retraction Syndrome ◽  
Abnormal Head ◽  
Ocular Deviation ◽  
Duane Retraction Syndrome

Objective: To report that maximum weakening of lateral rectus muscles can improve significant exotropia in primary position, abnormal head posture, retraction, narrowing of palpebral fissure and downshoot in exotropic duannes retraction syndrome. Case: A 12-year-old boy with exotropic Duane syndrome presented with downshoot and globe retraction in attempted adduction. Squint surgery was undertaken to correct the alignment and treat the secondary aberrant movements doing maximum weakening of the lateral rectus muscles by hang- back method. At 6 months follow up visit, there was improvement in abnormal head posture, reduction of ocular deviation with downshoot and stereoacuity. Conclusion: Supramaximal recession of lateral rectus muscles can correct exotropia with down shoot in a patient with Duane retraction syndrome. Nepal J Ophthalmol 2016; 8(15): 74-77

Outcomes of symmetric bilateral medial rectus recession in large-angle esotropic Duane syndrome

2020 ◽  
pp. 112067212096873
Author(s):  
Reza Nabie ◽  
Vahideh Manouchehri ◽  
Beheshteh Azad
Keyword(s):  
Large Angle ◽  
Medial Rectus ◽  
Successful Outcome ◽  
Primary Position ◽  
Head Posture ◽  
Duane Syndrome ◽  
Abnormal Head ◽  
Medical Reports ◽  
The Mean

Purpose: To evaluate the efficacy of symmetric bilateral medial rectus recession in large-angle esotropic Duane retraction syndrome (DRS) with moderate to severe globe retraction. Methods: In a retrospective study, medical reports of 30 patients with esotropia of equal or more than 20 prism diopters (pd) and moderate to serve globe retraction due to unilateral DRS who underwent symmetric bilateral medial rectus recession were reviewed. Age, gender, laterality, amblyopia, length of follow-up, pre- and postoperative measurements of primary position deviation, ocular ductions and severity of globe retraction and abnormal head posture were evaluated. A successful result was defined as decreasing esotropia to equal or less than 8 pd or equal or less than 8 pd of consecutive exotropia. Results: The mean age of patients at surgery was 13.7 ± 8.5 years old (range: 3–38). The mean preoperative esotropia measured 28.9 ± 9.1 pd in distance and 25.7 ± 7.2 pd in near, which decreased to 4.9 ± 6.1 pd in distance and 3.9 ± 8.8 pd in near postoperatively. The mean bilateral medial rectus recession was 4.9 ± 0.9 mm (range: 3–6 mm). The mean abnormal head posture improved from 19.1 ± 6.9 degrees (range: 10–30 degrees) to 3.3 ± 4.7 degrees (range: 0-15 degrees) postoperatively. At the last follow-up visit, 23 patients (76.7%) had a successful outcome. Conclusions: In the large-angle esotropic DRS patients with moderate to severe globe retraction, symmetric bilateral medial rectus recession, can be conducted to successfully resolve primary position deviation and abnormal head posture.

scholarly journals Unilateral Duane Retraction Syndrome Associated with Unilateral Congenital Cataract

2020 ◽  
Author(s):  
Majid Farvardin ◽  
Alireza Bolkheir
Keyword(s):  
Congenital Cataract ◽  
Systemic Disease ◽  
Positive Family History ◽  
Duane Syndrome ◽  
Retraction Syndrome ◽  
History Of ◽  
Ocular Deviation ◽  
Duane Retraction Syndrome ◽  
The Subject ◽  
Congenital Cataract Surgery

Purpose: To report unilateral congenital cataract in a case of ipsilateral Duane retraction syndrome. Case Report: In this case, we present a six year old girl who was referred with ocular deviation. She had a history of congenital cataract surgery in the left eye at the age of two years. The subject had no associated systemic disease, developmental delay, or positive family history. She was finally diagnosed as having Duane retraction syndrome in the same eye. Conclusion: Duane retraction syndrome can be associated with congenital cataract due to the matching time of gestational development of the lens to that of ocular and nonocular anomalies associated with Duane syndrome. As both of these disorders are rare, coincidence of both in the same person and the same eye by chance is a very remote possibility.

scholarly journals Comparative Study of Recession with Y- splitting Vs Recession Only of Lateral Rectus Muscle Surgery for up/down Shoot in Duane Retraction Syndrome

2021 ◽  
pp. 82-91
Author(s):  
Vangala Chandrasekhara Reddy ◽  
Sagili Chandrasekhara Reddy
Keyword(s):  
Rectus Muscle ◽  
Lateral Rectus ◽  
P Value ◽  
Normal Limits ◽  
Lateral Rectus Muscle ◽  
Retraction Syndrome ◽  
Group A ◽  
Duane Retraction Syndrome ◽  
Group B

Purpose: To evaluate and compare the effectiveness of lateral rectus muscle recession with Y-splitting versus recession only in the surgical treatment of up/down shoot in Duane retraction syndrome patients. Material and Methods: In this prospective study, 42 patients of Duane retraction syndrome with up/down shoot underwent surgery over a period of seven years, were divided into two groups of twenty one each.  In group A, Y-splitting of lateral rectus with recession and in group B, only lateral rectus recession was performed. In all the patients width of lateral rectus muscle at its insertion was measured. Postoperative results were compared and analyzed in terms of up/down shoot on adduction. Data analysis was performed using R Core Team (2020) R., and the P value <0.05 was taken as significant. Results: The Mean age at the time of surgery was 12.5 ± 4.5 years in group A, and 11.5 ± 3.9 years in group B (range, 5 to 22 years). Correction of up/down shoot was 100% in group A and 81% in group B. Five patients in group B showed no improvement of up/down shoot in whom the width of lateral rectus was 7mm or less and the surgery was recession of lateral rectus only. In these 5 patients, Y-splitting of lateral rectus was done in second sitting with good result Mean follow up was 12 months (range, 3 weeks to 3 years). Conclusions: Recession of lateral rectus muscle with Y-splitting is  more effective (100%) when compared to recession only, in correcting significant up/down shoot in Duane retraction syndrome. Lateral rectus muscle Y- splitting is not necessary in these patients with upshoot / down shoot if the width of the muscle at insertion is within normal limits (8.3 -12.5 mm). In these cases simple recession is enough. Lateral rectus muscle Y splitting is essential when the width of lateral rectus muscle at insertion is 7mm or less.

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.

scholarly journals Augmented superior rectus muscle transposition in management of defective ocular abduction

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohamed F. Farid ◽  
Ahmed E. M. Daifalla ◽  
Mohamed A. Awwad
Keyword(s):  
Nerve Palsy ◽  
Rectus Muscle ◽  
Muscle Transposition ◽  
Primary Position ◽  
Superior Rectus ◽  
Sixth Nerve Palsy ◽  
Abnormal Head ◽  
Duane Retraction Syndrome ◽  
Sixth Nerve ◽  
Superior Rectus Muscle

Abstract Background Superior rectus muscle transposition (SRT) is one of the proposed transposition techniques in the management of defective ocular abduction secondary to chronic sixth nerve palsy and esotropic Duane retraction syndrome (Eso-DRS). The aim of the current study is to report the outcomes of augmented SRT in treatment of Eso-DRS and chronic sixth nerve palsy. Methods a retrospective review of medical records of patients with Eso-DRS and complete chronic sixth nerve palsy who were treated by augmented full tendon SRT combined with medial rectus recession (MRc) when intraoperative forced duction test yielded a significant contracture. Effect on primary position esotropia (ET), abnormal head posture (AHP), limitation of ocular ductions as well as complications were reported and analyzed. Results a total of 21 patients were identified: 10 patients with 6th nerve palsy and 11 patients with Eso-DRS. In both groups, SRT was combined with ipsilateral MRc in 18 cases. ET, AHP and limited abduction were improved by means of 33.8PD, 26.5°, and 2.6 units in 6th nerve palsy group and by 31.1PD, 28.6°, and 2 units in Eso-DRS group respectively. Surgical success which was defined as within 10 PD of horizontal orthotropia and within 4 PD of vertical orthotropia was achieved in 15 cases (71.4%). Significant induced hypertropia of more than 4 PD was reported in 3 patients (30%) and in 2 patients (18%) in both groups, respectively. Conclusion augmented SRT with or without MRc is an effective tool for management of ET, AHP and limited abduction secondary to sixth nerve palsy and Eso-DRS. However, this form of augmented superior rectus muscle transposition could result in high rates of induced vertical deviation.

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 Evaluation of periosteal fixation of lateral rectus and partial vrt0 for cases of exotropic Duane retraction syndrome

2014 ◽  
Vol 62 (2) ◽  
pp. 204 ◽  
Author(s):  
Pradeep Sharma ◽  
Ruchi Tomer ◽  
Vimla Menon ◽  
Rohit Saxena ◽  
Anudeepa Sharma
Keyword(s):  
Lateral Rectus ◽  
Retraction Syndrome ◽  
Duane Retraction Syndrome
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