Lateral Rectus Resection in Type 1 Duane Retraction Syndrome (DRS)
Selcen Celik, MD; Asli Inal, MD; Osman Bulut Ocak, MD; Ebru Demet Aygit, MD; Ahmet Demirok, MD; Birsen Gökyigit, MD
University of Health Sciences Beyoglu Eye Research and Training
Introduction: Normally lateral rectus muscle resection is not recommended in Duane Retraction Syndrome (DRS). We aimed to assess the effect of lateral rectus muscle resection on abduction in DRS.
Methods: Nine patients whom lateral rectus resection for DRS performed were included. Ocular ductions, abnormal head position (AHP) and globe retraction existence were recorded. Globe retraction more than grade 1 was an exclusion criterion.
Results: Five patients were female and 4 patients were male. Mean age was 12,67±14,67 (2-50) years. Mean follow up time was 22.88±10.61 (9-46) months. While preoperative deviation was mean 19.66± 19.64(0-45) prism diopters (pd) at near, it was mean 20.11± 19.97(0-45) pd at distance. Limitation of abduction was noted as -4 in 3 patients, -3 in 3 patients, -2 in 2 patients and -1 in 1 patient. Five patients had AHP, one patient had mild globe retraction. Mean lateral rectus resection was 4.05±1.42 (2.5-6.0) mm, 6 mm was performed in only 2 patients. Postoperatively at six month, when mean near deviation was 2.66± 4.12 (0-10) pd, mean distance deviation was 2.00± 4.00 (0-10) pd . While limitation in abduction was improved in five patients, it remained unchanged in 4 patients. Abnormal head position resolved in all patients.
Discussion: Limiting resection of lateral rectus muscle to no more than 3.5 mm in selected patients with medial rectus muscle recession performed less than 4.0 mm is recommended.
Conclusion: Lateral rectus resection improves abduction in patients with Duane syndrome showing mild globe retraction.
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