Vertical Rectus Muscle Transposition for Bilateral Duane Syndrome

Britt, Michelle T.; Velez, Federico G.; Velez, Guillermo; Rosenbaum, Arthur L.

doi:10.1016/j.jaapos.2005.06.004

Cited by 36 publications

(46 citation statements)

References 30 publications

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“…Augmented vertical muscle transposition for Duane syndrome and sixth nerve palsy S Akar et al was enlarged up to 20-671 with no loss of adduction postoperatively. 1,[7][8][9] Our outcomes are consistent with those previously reported. The mean reduction in deviation was 95%, the AHP was reduced by 86%, the abduction improved in 100% of patients with a mean change of 42%, and a useful BSVF of B67% of normal was achieved with no loss of adduction for type 1 Duane syndrome cases following augmented transposition surgery.…”

Section: Discussionsupporting

confidence: 93%

“…Some authors have observed no adduction deficiencies, 7,12,13 although other authors have reported that 13-43% of patients who underwent augmented transposition suffered a mild limitation of adduction. 9,14 The occurrence of vertical deviation after augmented VRT to the LR muscle insertion was reported in 2-11% of patients. 8,9,12,13 Our results were similar to those previously reported.…”

Section: Discussionmentioning

confidence: 99%

“…9,14 The occurrence of vertical deviation after augmented VRT to the LR muscle insertion was reported in 2-11% of patients. 8,9,12,13 Our results were similar to those previously reported. The transposed muscles may achieve more stability if they are fixed to the sclera by posterior lateral fixation sutures, thereby avoiding side slippage during ocular rotations.…”

Section: Discussionmentioning

confidence: 99%

“…5,8 Ocular versions and ductions were recorded on a 6-point scale as follows: 0 ¼ full movement, À 1 ¼ restriction to 451 of abduction, À 2 ¼ movement limited to 301, À 3 ¼ movement limited to 151, À 4 ¼ unable to move the eye past the midline, and À 5 ¼ unable to rotate the eye to the midline. 9 We used the muscle force generation test to measure the force generated during attempted maximal abduction with the eye being held in extreme adduction and recorded on a scale of À 4 (no force generated) to 0 (normal force generated). 10 This test determines whether the paralysis is complete or incomplete.…”

Section: Methodsmentioning

confidence: 99%

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Vertical muscle transposition augmented with lateral fixation (Foster) suture for Duane syndrome and sixth nerve palsy

Akar

Gökyiğit

Pekel

et al. 2013

Eye

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Purpose To report the postoperative results of full-tendon vertical rectus transposition (VRT) augmented with lateral fixation suture for the treatment of type 1 Duane syndrome and sixth nerve palsy and to determine whether there was a decrease in the effect of the Foster suture over time. Methods This retrospective, consecutive case series included patients who underwent a full-tendon VRT transposition with lateral fixation for type 1 Duane syndrome or sixth nerve palsy. The primary outcome measures included deviation, abnormal head posture (AHP), abduction deficiency, and postoperative binocular single visual field (BSVF). Results Eighty-seven patients (87 eyes: 40 eyes with Duane syndrome and 47 eyes with sixth nerve palsy) were included in this study. In Duane syndrome patients, the deviation was reduced by a mean of 95%, the AHP was eliminated in 86% of patients, the abduction was improved by 42%, and a useful BSVF of B67% of normal was achieved at 1 year post operation. In sixth nerve palsy patients, the deviation was reduced by 99%, the abduction was improved by 59%, and a useful BSVF of B71% of normal was achieved at 1 year post operation. In both groups, the improvements in deviation angle and abduction were stable postoperatively. Sixteen patients needed reoperation for undercorrection. Conclusion VRT surgery with posterior fixation is an effective treatment method for complete sixth nerve palsy and Duane syndrome with esotropia, AHP, and abduction deficiency. The procedure carries a small risk of reoperation for undercorrection. The effect of the Foster suture did not decline over time.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Vertical muscle transposition augmented with lateral fixation (Foster) suture for Duane syndrome and sixth nerve palsy

Akar

Gökyiğit

Pekel

et al. 2013

Eye

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“…6,7 However, other studies have determined that globe retraction or up-or downshooting did not worsen. 8,9 We did not notice any worsening of retraction or shoots in our patients on follow-up. Sir, Enterococcus casseliflavus endophthalmitis due to metallic intraocular foreign body Enterococccus casseliflavus infection has been rarely implicated in ophthalmic infections.…”

Section: Correspondencementioning

confidence: 48%

Reply: Vertical rectus transposition in Duane’s syndrome: does co-contraction worsen?

Akar

Gökyiğit

Pekel

et al. 2015

Eye

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Superior Rectus Transposition and Medial Rectus Recession for Duane Syndrome and Sixth Nerve Palsy

Mehendale¹

2012

Arch Ophthalmol

109

126

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To describe our results using augmented temporal superior rectus transposition (SRT) with adjustable medial rectus muscle recession (MRc) for treatment of Duane syndrome and sixth nerve palsy.Methods: Retrospective surgical case review of patients undergoing SRT. Preoperative and postoperative orthoptic measurements were recorded. Minimum follow-up was 6 weeks. Main outcome measures included the angle of esotropia in the primary position and the angle of head turn. Secondary outcomes included duction limitation, stereopsis, and new vertical deviations.Results: The review identified 17 patients: 10 with Duane syndrome and 7 with sixth nerve palsy. Combining SRT with MRc improved esotropia from 44 to 10 prism diopters (P Ͻ .001), reduced abduction limitation from −4.3 to −2.7 (P Ͻ.001), and improved compensatory head posture from 28°to 4°(P Ͻ .001). Stereopsis was recovered in 8 patients (P =.03). Three patients required a reoperation: 1 for overcorrection and 2 for undercorrection. A new primary position vertical deviation was observed in 2 patients with complex sixth nerve palsy and none with Duane syndrome. No patient described torsional diplopia.Conclusions: Superior rectus transposition allows for the option of simultaneous MRc in patients with severe abduction imitation who require transposition surgery. Combining SRT and MRc improved esotropia, head position, abduction limitation, and stereopsis without inducing torsional diplopia.

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Vertical Rectus Muscle Transposition for Bilateral Duane Syndrome

Cited by 36 publications

References 30 publications

Vertical muscle transposition augmented with lateral fixation (Foster) suture for Duane syndrome and sixth nerve palsy

Vertical muscle transposition augmented with lateral fixation (Foster) suture for Duane syndrome and sixth nerve palsy

Reply: Vertical rectus transposition in Duane’s syndrome: does co-contraction worsen?

Superior Rectus Transposition and Medial Rectus Recession for Duane Syndrome and Sixth Nerve Palsy

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