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Augmented superior rectus transposition procedure in Duane retraction syndrome compared with sixth nerve palsy

  • Neurophthalmology
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Abstract

Purpose

Superior rectus transposition (SRT) with medial rectus recession has been used for the treatment of sixth nerve palsy and esotropic Duane retraction syndrome (DRS). The purpose of this study was to compare the results of augmented SRT (with scleral fixation) without medial rectus recession in DRS and sixth nerve palsy.

Methods

Patients with unilateral esotropic DRS (DRS group) and sixth nerve palsy were included in this prospective, comparative study and underwent SRT. Preoperative forced duction testing was negative or slightly positive in both groups. Prospective measurements were compared between the two groups.

Results

There were 11 patients in the DRS group and 11 patients in the sixth nerve palsy group. The mean preoperative esotropia decreased from 20.9 ± 6.0 prism diopter (PD) at far to 13.2 ± 5.8 PD in the DRS group (P = 0.003). The same measurement improved from 28.0 ± 8.5 PD to 8.4 ± 7.3 PD in the sixth nerve palsy group (P = 0.003). In the sixth nerve palsy group, the improvement in primary gaze esotropia and abnormal head posture was more than the DRS group (Both P < 0.001).The average dose effect for SRT was 7.8 ± 2.2 PD in the DRS group and 19.2 ± 4.6 PD in the sixth nerve palsy group. Although objective intorsion was significantly induced after SRT, subjective torsion was not significant after surgery in both groups.

Conclusion

SRT appears to be more effective in improving primary gaze deviation and head posture in sixth nerve palsy compared with DRS. Subjective torsional and vertical diplopia were rare in both groups.

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References

  1. Rosenbaum AL (2004) Costenbader lecture. The efficacy of rectus muscle transposition surgery in esotropic Duane syndrome and VI nerve palsy. J AAPOS 8:409–419

    Article  PubMed  Google Scholar 

  2. Velez FG, Foster RS, Rosenbaum AL (2001) Vertical rectus muscle augmented transposition in Duane syndrome. J AAPOS 5:105–113

    Article  CAS  PubMed  Google Scholar 

  3. Ruth AL, Velez FG, Rosenbaum AL (2009) Management of vertical deviations after vertical rectus transposition surgery. J AAPOS 13:16–19

    Article  PubMed  Google Scholar 

  4. Lee YH, Lambert SR (2017) Outcomes after superior rectus transposition and medial rectus recession versus vertical recti transposition for sixth nerve palsy. Am J Ophthalmol 177:100–105

    Article  PubMed  Google Scholar 

  5. Johnston SC, Crouch ER Jr, Crouch ER (2006) An innovative approach to transposition surgery is effective in treatment of Duane’s syndrome with esotropia. Invest Ophthalmol Vis Sci 47:e Abstract 2475

  6. Mehendale RA, Dagi LR, Wu C, Ledoux D, Johnston S, Hunter DG (2012) Superior rectus transposition and medial rectus recession for Duane syndrome and sixth nerve palsy. Arch Ophthalmol 130:195–201

    Article  PubMed  PubMed Central  Google Scholar 

  7. Yang S, Mackinnon S, Dagi LR, Hunter DG (2014) Superior rectus transposition vs medial rectus recession for treatment of esotropic Duane syndrome. JAMA Ophthalmol 132:669–675

    Article  PubMed  Google Scholar 

  8. Tibrewal S, Sachdeva V, Ali MH, Kekunnaya R (2015) Comparison of augmented superior rectus transposition with medial rectus recession for surgical management of esotropic Duaneretraction syndrome. J AAPOS 19:199–205

    Article  PubMed  Google Scholar 

  9. Velez FG, Oltra E, Isenberg SJ, Pineles SL (2014) Comparison of augmented superior rectus transposition with medial rectus recession for surgical management of esotropic Duane retraction syndrome. J AAPOS 18:457–460

    Article  PubMed  PubMed Central  Google Scholar 

  10. Merino P, Merino M, Gómez De Liaño P, Blanco N (2012) Horizontal rectus surgery in Duane syndrome. Eur J Ophthalmol 22:125–130

    Article  PubMed  Google Scholar 

  11. Dotan G, Klein A, Ela-Dalman N, Shulman S, Stolovitch C (2012) The efficacy of asymmetric bilateral medial rectus muscle recession surgery in unilateral, esotropic, type 1 Duane syndrome. J AAPOS 16:543–547

    Article  PubMed  Google Scholar 

  12. Natan K, Traboulsi EI (2012) Unilateral rectus muscle recession in the treatment of Duane syndrome. J AAPOS 16:145–149

    Article  PubMed  Google Scholar 

  13. Mehta A (1999) Chief complaint, history, and physical examination. In: Rosenbaum AL, Santiago P (eds) Clinical strabismus management. WB Saunders, Philadelphia, pp 325–346

    Google Scholar 

  14. Kekunnaya R, Kraft S, Rao VB, Velez FG, Sachdeva V, Hunter DG (2015) Surgical management of strabismus in Duane retraction syndrome. J AAPOS 19:63–69

    Article  PubMed  Google Scholar 

  15. Yazdian Z, Rajabi MT, Ali Yazdian M, Rajabi MB, Akbari MR (2010) Vertical rectus muscle transposition for correcting abduction deficiency in Duane’s syndrome type 1 and sixth nerve palsy. J Pediatr Ophthalmol Strabismus 47:96–100

    Article  PubMed  Google Scholar 

  16. Hotchkiss MG, Miller NR, Clark AW, Green WR (1980) Bilateral Duanes’s retraction syndrome: A clinical-pathologic case report. 98:870–4

  17. Britt MT, Velez FG, Thacker N, Alcorn D, Foster RS, Rosenbaum AL (2004) Surgical management of severe cocontraction, globe retraction, and pseudo-ptosis in Duane syndrome. J AAPOS 8:362–367

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar, Qazvin SQ, Tehran, 13352, Iran

    Mohammadreza Akbari, Setareh Shomali, Arash Mirmohammadsadeghi & Masoud Aghsaei Fard

Authors
  1. Mohammadreza Akbari
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  2. Setareh Shomali
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  3. Arash Mirmohammadsadeghi
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  4. Masoud Aghsaei Fard
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Corresponding author

Correspondence to Masoud Aghsaei Fard.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Tehran University of Medical Science and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Institution at which the study was conducted: Farabi Eye Hospital

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Akbari, M., Shomali, S., Mirmohammadsadeghi, A. et al. Augmented superior rectus transposition procedure in Duane retraction syndrome compared with sixth nerve palsy. Graefes Arch Clin Exp Ophthalmol 256, 983–987 (2018). https://doi.org/10.1007/s00417-017-3885-5

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  • DOI: https://doi.org/10.1007/s00417-017-3885-5

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