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

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

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.

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
LR rec* or MR rec 20
Rec+Y splitting 10
MR rec+LR res 2
LR rec* or MR rec 1
Rec+Y splitting 1
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)
15.0±6.3 1.5±2.4 13.5
12.1±2.8 1.5±2.1 10.6
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
1–10° 11–20° 21–30° 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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