Surgical management of bilateral esotropic Duane syndrome

Sachdeva, Virender; Kekunnaya, Ramesh; Gupta, Amit; Bhoompally, Venkateshwar Rao

doi:10.1016/j.jaapos.2012.06.008

Cited by 13 publications

(11 citation statements)

References 16 publications

(19 reference statements)

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“…Their average recession was greater than in our and the Sachdeva et al 10 series. Naton et al 11 also reported a high success rate with large single muscle surgery.…”

Section: Discussioncontrasting

confidence: 63%

“…Sachdeva et al 10 reported an average 5.5 to 5.7 mm MR recession with or without LR recession in 14 patients with ET DRS and achieved 85.7% success in correcting ET; they also observed satisfactory improvement in associated globe retraction and AHP. Consistent with the results of that study, our observations also support that weakening co-contracting muscles is effective in eliminating globe retraction.…”

Section: Discussionmentioning

confidence: 96%

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Modified Y-splitting Procedure for the Treatment of Duane Retraction Syndrome

Altıntaş¹,

Arifoğlu²,

Köklü³

2015

tjo

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Objectives:To present the outcomes of modified lateral rectus Y-splitting combined with either unilateral or bilateral horizontal rectus recession in Duane Retraction Syndrome (DRS) with significant upshoot or downshoot.Materials and Methods:A total of 12 patients including 10 patients with Type I DRS and 2 with Type III DRS underwent modified Y-splitting surgery. Amount of additional recessions varied with the degree of preoperative deviation by intraoperative adjustable suture technique. Preoperatively 3 patients had esotropia (ET), 6 had exotropia (XT), and 3 patients had orthotropia. The mean preoperative deviation was 19.3 prism diopters (PD) (range, 18-20 PD) in ET patients and 19.2 PD (range, 16-20 PD) in XT patients.Results:Postoperatively, all patients had significant correction in horizontal deviation and aligned within 4 PD of orthotropia, and no patients exhibited abnormal head posture. Co-contraction and globe retraction were markedly reduced and abnormal ocular vertical movement disappeared or significantly decreased in all cases. No patients experienced recurrence of ocular motility disorders in the mean 26-month (range, 13-66 months) follow-up period.Conclusion:Modified Y-splitting surgery combined with co-contracting horizontal muscle recession technique seems to be a safe and effective treatment in DRS.

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“…Their average recession was greater than in our and the Sachdeva et al 10 series. Naton et al 11 also reported a high success rate with large single muscle surgery.…”

Section: Discussioncontrasting

confidence: 63%

Section: Discussionmentioning

confidence: 96%

Modified Y-splitting Procedure for the Treatment of Duane Retraction Syndrome

Altıntaş¹,

Arifoğlu²,

Köklü³

2015

tjo

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“…50 In bilateral esotropic DS cases, the deviation in primary position can be as great as 70 D . 51 Bilateral medial rectus recessions in these patients reduce the adducting ability of the operative eye. 2 The surgical dose depends on the magnitude of deviation in primary gaze, the range of ductions, and the amount of restriction on forced ductions.…”

Section: Bilateral Esotropic and Exotropic Dsmentioning

confidence: 99%

Transposition procedures in Duane retraction syndrome

Doyle

Hunter

2019

Journal of American Association for Pediatric Ophthalmology and

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“…Cases with bilateral esotropic DRS, which is the commonest presentation, 47 are most often corrected by bilateral MR recessions, depending on the primary position deviation, muscle tightness and limitation of ductions. Sachdeva et al 98 studied 14 patients with bilateral esotropic DRS and found 86% success rate with a mean surgical dose of 5.6 mm (range being 5–7 mm) for bi-MR recessions. The mean preoperative esotropia in this series was 38 PD, with none of the patients developing significant postoperative adduction limitation.…”

Section: Management Of Drsmentioning

confidence: 99%

Duane retraction syndrome: causes, effects and management strategies

Kekunnaya¹,

Negalur²

2017

OPTH

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Duane retraction syndrome (DRS) is a congenital eye movement anomaly characterized by variable horizontal duction deficits, with narrowing of the palpebral fissure and globe retraction on attempted adduction, occasionally accompanied by upshoot or down-shoot. The etiopathogenesis of this condition can be explained by a spectrum of mechanical, innervational, neurologic and genetic abnormalities occurring independently or which influence each other giving rise to patterns of clinical presentations along with a complex set of ocular and systemic anomalies. Huber type I DRS is the most common form of DRS with an earlier presentation, while Huber type II is the least common presentation. Usually, patients with unilateral type I Duane syndrome have esotropia more frequently than exotropia, those with type II have exotropia and those with type III have esotropia and exotropia occurring equally common. Cases of bilateral DRS may have variable presentation depending upon the type of presentation in each eye. As regards its management, DRS classification based on primary position deviation as esotropic, exotropic or orthotropic is more relevant than Huber’s classification before planning surgery. Surgical approach to these patients is challenging and must be individualized based on the amount of ocular deviation, abnormal head position, associated globe retraction and overshoots.

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Surgical management of bilateral esotropic Duane syndrome

Cited by 13 publications

References 16 publications

Modified Y-splitting Procedure for the Treatment of Duane Retraction Syndrome

Modified Y-splitting Procedure for the Treatment of Duane Retraction Syndrome

Transposition procedures in Duane retraction syndrome

Duane retraction syndrome: causes, effects and management strategies

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