Surgical Results in Duane Retraction Syndrome

Seong Bae Park; Seung Ah Chung; Jong Bok Lee

doi:10.3341/jkos.2009.50.6.893

Journal List > J Korean Ophthalmol Soc > v.50(6) > 1008581

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Park, Chung, and Lee: Surgical Results in Duane Retraction Syndrome

Original Article

J Korean Ophthalmol Soc 2009;50(6):893-897.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.6.893

Surgical Results in Duane Retraction Syndrome

Seong Bae Park, MD, Seung Ah Chung, MD, Jong Bok Lee, MD

The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea

Address reprint requests to Jong Bok Lee, MD Department of Ophthalmology, Yonsei University College of Medicine #250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea Tel: 82-2-2228-3574, Fax: 82-2-312-0541, E-mail: 491209@yuhs.ac

Received 10 October 2008 Accepted 7 April 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report the clinical characteristics and the results of a series of patients treated with various strabismus surgery techniques for Duane retraction syndrome (DRS).

Methods

Thirty-eight patients with DRS undergoing surgical treatment were retrospectively reviewed. In all patients, ocular alignment, abnormal head posture and ocular motility disturbance were assessed both preoperatively and postoperatively. The patients were treated with appropriate horizontal muscle recession, Y-splitting combined with horizontal muscle recession, medial rectus recession and lateral rectus resection.

Results

The incidence of DRS was greater in females and in the left eye. Type 1 was the most common, and esodeviation was seen most frequently in the primary position. The esotropic patients with DRS turned their faces toward the affected eyes, while the exotropic patients with DRS turned away from the affected eyes. The deviation in the primary position was reduced from an average of 15.0 prism diopters (PD) to 1.5PD. The face turn was reduced from an average of 17.5 degrees to 1.2 degrees.

Conclusions

The primary deviation and abnormal head posture found in DRS can be improved by proper preoperative evaluation and adequate choice of surgical methods.

Keywords: Abnormal head posture, Duane retraction syndrome, Surgical outcomes

References

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Table 1.

Gender and laterality of DRS patients

	Number of patients (%) (N=38)
Male	10 (26.3%)
Female	28 (73.7%)
Right eye	12 (31.6%)
Left eye	24 (63.2%)
Both eyes	2 (5.2%)

Table 2.

Ocular deviation for each type of DRS

Type	Esotropia	Exotropia	Total
I	21	11	32 (84.2%)
II	0	2	2 (5.3%)
III	1	3	4 (10.5%)
Total	22 (57.9%)	16 (42.1%)	38 (100.0%)

Table 3.

Patient distribution for type and surgical method

Type	Surgery	Number of patients
Ⅰ	LR rec^* or MR rec^†	20
	Rec+Y splitting	10
	MR rec+LR res^‡	2
Ⅱ	LR rec^* or MR rec^†	1
	Rec+Y splitting	1
Ⅲ	LR rec^* or MR rec^†	2
	Rec+Y splitting	2

^* LR rec=lateral rectus recession

^† MR rec=medial rectus recession

^‡ LR res=lateral rectus resection.

Table 4.

Postoperative change in ocular deviation for each surgical method

Surgery	Preoperative deviation (PD)	Postoperative deviation (PD) 2.1±2.8	Difference§(PD)
LR rec^* or MR rec^†	14.6±5.9	2.1±2.8	12.5
Rec+Y splitting	13.5±3.9	0.5±1.1	13.0
MR rec+LR res^‡	30.0±7.1	1.5±2.1	28.5
Total	15.0±5.9	1.5±2.3	13.5

^* LR rec=lateral rectus recession

^† MR rec=medial rectus recession

^‡ LR res=lateral rectus resection

^§ Difference=preop deviation–postop deviation.

Table 5.

Postoperative change in ocular deviation for each type

Type	Preoperative deviation (PD)	Postoperative deviation (PD)	Difference^*(PD)
Ⅰ	15.0±6.3	1.5±2.4	13.5
Ⅱ	12.1±2.8	1.5±2.1	10.6
Ⅲ	16.5±3.4	1.3±2.5	15.2
Total	15.0±5.9	1.5±2.3	13.5

^* Difference=preop deviation–postop deviation.

Table 6.

Postoperative change of face turn degrees for each surgical method

	Number of patients (N=35)
Surgery	Preoperative degrees of face turn				Postoperative degrees of face turn
Surgery	0°	1–10°	11–20°	21–30°	0°	1–10°	11–20°	21–30°
LR rec^* or MR rec^†	0	0	16	4	13	7	0	0
Rec+Y splitting	0	0	11	2	11	2	0	0
MR rec+LR res^‡	0	0	0	2	2	0	0	0
Total(°, Mean± SD)	17.5±6.6				1.2±2.3

^* LR rec=lateral rectus recession

^† MR rec=medial rectus recession

^‡ LR res=lateral rectus resection.

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