New considerations about Duane's syndrome

Souza-Dias, Carlos

doi:10.1590/s0034-72802009000200009

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…If abduction is normal, exotropia can be present due to very strong contraction of the lateral rectus; however, in cases with less than normal abduction, exotropia can still be present due to synergistic divergence, or synergistic abduction: when the patient tries to adduct the affect eye, it abducts instead. 1,2 Up- and downshoots commonly occur in patients with Duane syndrome. The etiology of these anomalous movements is debatable.…”

Section: Introductionmentioning

confidence: 99%

Isolated Y-Splitting and Recession of the Lateral Rectus Muscle in Patients with Exo-Duane Syndrome

Velez¹,

Velez²,

Hendler³

et al. 2012

Strabismus

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Purpose Weakening of both horizontal rectus muscles is performed for patients with Duane syndrome and significant misinnervation of the lateral rectus (LR) muscle resulting in strabismus, limitation to ocular rotations, and globe retraction. In patients with severe up-/downshoots, a Y-splitting of the LR is often recommended. The purpose of this study was to evaluate the efficacy of isolated unilateral LR recession-Y splitting in exo-Duane patients with limitation to adduction and up-/downshoots. Methods Retrospective review of the records of consecutive patients with exo-Duane syndrome and up/downshoots who underwent isolated Y-splitting-recession of the affected LR. Results The records of 10 patients were reviewed (mean age at surgery 23 ± 21 years). The Y-split was performed 10 mm posterior to the insertion and was combined with a mean LR recession of 8.7 ± 2.9 mm. Torticollis decreased from 12.7 ± 4.4° to 4.8 ± 5.3° (P = 0.003). Exotropia improved from 18.4 ± 7.3 to 6.2 ± 5.9 PD postoperatively (P < 0.001). Exotropia in contralateral gaze improved from 33.7 ± 11.8 to 18.7 ± 18.1 PD postoperatively (P = 0.09). No significant postoperative changes in esotropia in ipsilateral gaze, vertical deviations, or ocular rotations in adduction or abduction were observed. Downshoots were significantly decreased (P = 0.01), and there was a trend toward improvement of upshoots (P = 0.07). There were no overcorrections, although 3 patients required additional LR weakening and transposition. Conclusions LR Y-splitting–recession improves ocular alignment, torticollis, and up-/downshoots. LR recession improves ocular alignment and torticollis, while the addition of a Y-split procedure improves up-/downshoots.

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Section: Introductionmentioning

confidence: 99%

Isolated Y-Splitting and Recession of the Lateral Rectus Muscle in Patients with Exo-Duane Syndrome

Velez¹,

Velez²,

Hendler³

et al. 2012

Strabismus

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Duane Syndrome

Kushner¹

2017

Strabismus

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Review of the major findings about Duane retraction syndrome (DRS) leading to an updated form of classification

2010

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In view of all the reported evidence by electromyography in the 1970s, by histology in the 1980s, and by cerebral imagery since the 2000s, Duane retraction syndrome (DRS) has been described as the consequence of a congenital anomaly of the 6th cranial nerve nuclei with aberrant innervations by supply from the 3rd cranial nerve. Both genetic and environmental factors are likely to play a role when the cranial nerves and ocular muscles are developing between the 4th and the 8th week of gestation. New data from eye movement recordings contributed to better understanding the binocular control of saccades. Modeling of saccades in DRS seems promising for the quantification of the innervational deficit and the mechanical properties of the eye plant. The usual clinical classification of DRS needs to be updated in order to match more accurately the underlying dysinnervation of the extra ocular muscles and to illustrate the continuum that exists between the various forms. This review aims to summarize the major findings about DRS and to guide the clinician in the surgical management of this particular form of strabismus.

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New considerations about Duane's syndrome

Cited by 3 publications

References 6 publications

Isolated Y-Splitting and Recession of the Lateral Rectus Muscle in Patients with Exo-Duane Syndrome

Isolated Y-Splitting and Recession of the Lateral Rectus Muscle in Patients with Exo-Duane Syndrome

Duane Syndrome

Review of the major findings about Duane retraction syndrome (DRS) leading to an updated form of classification

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