Surgical management of severe cocontraction, globe retraction, and pseudo-ptosis in Duane syndrome

Britt, Michelle T.; Velez, Federico G.; Thacker, Neepa; Alcorn, Deborah M.; Foster, Roger S.; Rosenbaum, Arthur L.

doi:10.1016/j.jaapos.2004.04.004

Cited by 19 publications

(14 citation statements)

References 24 publications

(45 reference statements)

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“…[4][5][6][7][8]14,15 In our surgical subset of 18 patients (14 type I and 4 type II), the majority had an excellent surgical outcome with significant improvements in AHP and FPP alignment.…”

Section: Discussionmentioning

confidence: 76%

“…Surgical outcomes in our cohort of our 14 ET patients was comparable to those in a study by Mehendale and colleagues, 14 where improvements in ET from 44 to 10 PD, head posture from 28 to 4 degrees, and abduction limitation from -4.3 to -2.7 was seen in 10 patients after superior rectus transposition with adjustable medial rectus muscle recession. 15 Velez and colleagues 4 reported improved torticollis from 12.7 to 4.8 PD, improved XT from 33.7 to 18 PD, and improvement in downshoots after Y-splitting recession of the affected lateral rectus in 10 patients. In contrast with the modest improvement in upshoots, downshoots, and fissure-narrowing/globe retraction we observed, 1 small study reported the complete elimination of upshoots and downshoots, globe retraction, and abnormal head posture after a lateral rectus muscle recession with Ysplitting and ipsilateral medial rectus recession in 6 patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Duane syndrome: Clinical features and surgical management

Kalevar

Tone

Flanders

2015

Canadian Journal of Ophthalmology

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Duane syndrome: Clinical features and surgical management

Kalevar

Tone

Flanders

2015

Canadian Journal of Ophthalmology

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“…Others reported that this combined technique in the involved eye led to dramatic improvement in patients with moderate globe retraction on adduction. 17,18,[39][40][41] It is noteworthy that our cohort was considerably older (8.75±3.13 years) than in most other common strabismus studies. Kubota et al 23 reported that 92.7% of their patients with DRS underwent surgery after age 3 years, and Waddell et al 9 suggested that surgery for DRS should be performed before age 8 years.…”

Section: Discussionmentioning

confidence: 99%

Contralateral lateral rectus muscle recession in patients with Duane retraction syndrome type 3

Snir

Dotan

Friling

et al. 2013

Eye

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Aims The aim of this study was to evaluate the motor, sensory, functional, and head posture results of recession of the lateral rectus muscle contralateral to the involved eye in patients with exotropic Duane retraction syndrome (DRS) type 3. Methods This was a retrospective, longitudinal, observational study of a consecutive clinical case series. Of the 11 patients with DRS type 3 operated on at a tertiary medical center from 1977 to 2012, 8 underwent recession of the lateral rectus muscle contralateral to the involved eye (with combined Y-splitting of ipsilateral lateral rectus muscle in 3 of them). Full ophthalmic, orthoptic, and neurological examination was performed before and after surgery. Main outcome measures included intragroup changes in motor misalignment, abnormal head turn, ocular upshoot, and stereopsis. Results Mean patient age was 8.75 ± 3.1 years at surgery. Mean exodeviation for distance was À 17.3±3.5 prism diopters (PD) preoperatively and À 4.0±6.1 PD postoperatively; corresponding values for near were À 23.1 ± 7.2 PD and À 5.9 ± 8.7 PD. Motor deviation improved by 77% for distance (P ¼ 0.017) and 74.5% for near (P ¼ 0.01). In 7/8 patients, the postoperative residual exodeviation (distance and near) was o8.0 PD. There was an 80% improvement in head turn, from 15.3±41 before surgery to 3.1 ± 5.01 after (P ¼ 0.01). Stereopsis improved significantly in 6/8 patients. Findings remained stable during follow-up (mean duration 35.9 ± 50.8 months, range 5-132 months). Conclusions Contralateral lateral rectus muscle recession appears to be a promising technique for the treatment of moderate unilateral DRS type 3, with patients showing significant motor and functional improvement and a decrease in head turn.

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“…3 For treatment of esotropic Duane syndrome with severe globe retraction, transposition of the lateral half of the vertical rectus muscles to the lateral rectus insertion was combined with fixation of the lateral rectus muscle to the periosteum of the lateral orbital wall. [4][5][6][7] Although the outcome of periosteal fixation of the lateral rectus muscle may be excellent, exposing the adjacent periosteum and passing the needle through it is technically difficult. 5 In our procedure, the lateral rectus muscle is instead attached to the lateral canthal tendon.…”

Section: Discussionmentioning

confidence: 99%