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Vertical rectus muscle transposition for bilateral Duane syndrome
Michelle T Britt1, Federico G Velez, Guillermo Velez
1Jules Stein Eye Institute, University of California-Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095, USA.
Summary
Vertical rectus muscle transposition effectively corrects esotropia in bilateral Duane syndrome, improving alignment and motility without limiting adduction. This surgical approach offers a promising solution for patients with this rare condition.
Area of Science:
- Ophthalmology
- Strabismus Surgery
- Pediatric Ophthalmology
Background:
- Duane syndrome is a congenital eye movement disorder.
- Esotropia, an inward turning of the eye, can occur in bilateral Duane syndrome.
- Medial rectus recession may worsen outcomes in bilateral Duane syndrome.
Purpose of the Study:
- To evaluate the efficacy of vertical rectus muscle transposition in treating esotropia in bilateral Duane syndrome.
- To assess the impact of this procedure on ocular alignment, motility, and adduction.
- To determine if posterior fixation sutures improve outcomes in larger deviations.
Main Methods:
- Retrospective review of 11 patients with bilateral Duane syndrome and esotropia.
- All patients underwent vertical rectus muscle transpositions, with some augmented by posterior fixation sutures.
- Surgical outcomes, including esotropia reduction, abduction, adduction, and stereovision, were analyzed.
Main Results:
- Significant reduction in esotropia at distance (22.8 to 2.0 PD) and near (21.0 to 1.2 PD) (P < 0.001).
- All patients showed improved abduction; 9 out of 11 maintained or gained adduction.
- Three patients achieved fusion with good stereovision; follow-up averaged 22.2 months.
Conclusions:
- Vertical rectus muscle transposition is an effective surgical treatment for esotropia in bilateral Duane syndrome.
- The procedure successfully improves ocular alignment and motility.
- Adduction is generally preserved, making it a favorable surgical option.