Horizontal rectus surgery in Duane syndrome

To study the results of horizontal rectus recession for treatment of Duane syndrome.

This was a retrospective study of 17 patients with Duane syndrome who underwent strabismus surgery between 2000 and 2008 with medial rectus recession for esotropic deviation or lateral rectus recession for exotropic deviation. The amount of surgery varied individually with the angle of deviation and abnormal head posture. Head turn was graded as mild, moderate, or severe. Botulinum toxin was injected in specific cases. An angle of deviation less than 10 PD and head turn less than 5º after surgery were considered good results.

Treatment was successful in 12 cases (70.58%) and unsuccessful in 5 (4 with type I Duane syndrome and one with type III Duane syndrome); in 3 patients the deviation was undercorrected and 2 it was overcorrected. Ipsilateral medial rectus recession of less than 5 mm was performed in 12 patients, although 1 case with a recession of 7 experienced secondary adduction limitation. Abduction limitation was slightly improved in 29.41%. Mean follow-up was 50.59 months.

Moderate horizontal rectus recession is a simple and effective procedure in most patients with Duane syndrome and no secondary duction limitations. The technique only slightly improved abduction in one-third of the cases.