Lateral rectus muscle recession for intermittent exotropia with anomalous head position in type 1 Duane’s retraction syndrome
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We questioned how to treat for intermittent exotropia in type 1 Duane’s retraction syndrome (DRS). To avoid secondary abduction deficit and late overcorrection on the affected eye following ipsilateral lateral rectus (LR) recession, we performed less correction of the lateral rectus (LR) recession to correct exodeviation and anomalous head position (AHP). We report the surgical outcomes of LR recession in patients with unilateral type 1 DRS.
Four patients who underwent less correction of LR recession in the affected eye to correct intermittent exotropia and AHP to the contralateral side in type 1 DRS were enrolled. Data on preoperative and postoperative angle of exodeviation, degree of AHP, ocular motility, global retraction, palpebral fissure change, and complications were retrospectively obtained. Success was defined as postoperative deviation within 8 prism diopters (PD) and AHP < 5°.
The preoperative angles of exodeviation and AHP were significantly improved after LR recession. The median grade of abduction limitation was improved from − 1.3 to − 0.8 postoperatively. Final median value of deviation was orthotropia in the primary position of the eye with the normal motility. All patients had successful outcomes without overcorrection or further abduction limitation in DRS eyes.
Less correction of ipsilateral LR recession may be useful for correcting intermittent exotropia and AHP in patients with type 1 DRS.
KeywordsDuane retraction syndrome Intermittent exotropia Lateral rectus recession Modified grading
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The study was approved by the Institutional Review Board of Samsung Medical Center. All procedures performed in this study were in accordance with the ethical standards of Samsung Medical Center and followed the tenets of the Declaration of Helsinki.
For this type of study, formal consent is not required.
- 10.Jampolsky A (1986) Strategies in strabismus surgery. In: Metz HS (ed) Pediatric ophthalmology and strabismus: transactions of the New Orleans Academy of Ophthalmology. Raven, New York, pp 366–367Google Scholar
- 12.Ansons AM, Davies H (2001) Diagnosis and management of ocular motility disorders (3rd ed.). Blackwell Science, London, pp 104–105Google Scholar
- 14.Kestenbaum A (1961) Clinical methods of neuro-ophthalmological examinations, 2nd edn. Grune & Stratton, New York and LondonGoogle Scholar