Surgical Outcome of Patients With Unilateral Exotropic Duane Retraction Syndrome Publisher Pubmed



Akbari MR¹ ; Masoumi A¹ ; Masoomian B¹ ; Mirmohammadsadeghi A¹ ; Mehrpour M¹
Source: Journal of AAPOS Published:2020

Abstract

Purpose: To describe the clinical features and surgical outcomes of patients with unilateral exotropic Duane retraction syndrome (DRS). Methods: The medical records of patients with unilateral exotropic DRS who underwent surgery between March 2015 and February 2018 were reviewed retrospectively. Results: A total of 40 patients (mean age, 18.75 ± 12.54 years; 21 males [53%]) were included. In 28 patients (70%) the left eye was involved. All patients had globe retraction and head turn toward the opposite side of the affected eye. Remarkable upshoot/downshoot movement was detectable in 11 patients (28%). The mean deviation for near and distance improved from 24.37Δ ± 12.34Δ (range, 6Δ-77Δ) and 19.67Δ ± 10.76Δ (range, 4Δ-60Δ) to 4.25Δ ± 8.61Δ (range, 0Δ-50Δ) and 2.62Δ ± 6.15Δ (range, 0Δ-35Δ) after the first surgery (P <0.001 for near and far deviation). Mean postoperative follow-up was 7.82 ± 9.45 months. Two patients required reoperation. Different types of surgeries, including lateral rectus recession (with or without Y-splitting), lateral and medial rectus recession (with or without Y-splitting of the lateral rectus muscle), bilateral lateral rectus recession, and lateral rectus recession with vertical rectus nasal transposition were performed. Twenty-four patients (60%) were successfully treated with only a single recession of the ipsilateral lateral rectus muscle. The mean lateral rectus recession was 7.45 ± 0.73 mm (range, 6–8.5 mm), and the mean dose–response for lateral rectus recession was 2.79Δ ± 0.64Δ/mm for near and 2.45Δ ± 0.67Δ/mm for distance. Conclusions: Simple lateral rectus recession (with or without Y-splitting), even in the presence of significant deviation (through 35Δ), seems to be a successful procedure for management of patients with unilateral exotropic DRS. © 2020 American Association for Pediatric Ophthalmology and Strabismus