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Horizontal rectus surgery in Duane syndrome.

Pilar Merino¹, María Merino, Pilar Gómez De Liaño

¹Ocular Motility Section, Department of Ophthalmology, Hospital Gregorio Marañón, Madrid, Spain. pilimerino@gmail.com

European Journal of Ophthalmology

|July 5, 2011

Summary

Horizontal rectus recession effectively treated most Duane syndrome cases, achieving good results in 70.58%. This strabismus surgery showed slight improvement in abduction but should be used cautiously to avoid secondary limitations.

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Area of Science:

Ophthalmology
Pediatric Ophthalmology
Strabismus Surgery

Background:

Duane syndrome is a congenital eye movement disorder characterized by limited horizontal eye movement.
Surgical intervention, including horizontal rectus recession, is often considered for managing strabismus and abnormal head posture in Duane syndrome.

Purpose of the Study:

To evaluate the outcomes of horizontal rectus recession surgery for treating Duane syndrome.
To assess the efficacy and potential complications of this surgical approach.

Main Methods:

A retrospective analysis of 17 patients with Duane syndrome who underwent strabismus surgery between 2000 and 2008.
Procedures included medial rectus recession for esotropic deviation or lateral rectus recession for exotropic deviation, with surgical amounts tailored to individual deviation angles and head posture.

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Good outcomes were defined as an angle of deviation <10 prism diopters (PD) and head turn <5 degrees post-operatively.

Main Results:

Successful treatment was achieved in 12 patients (70.58%), with 5 cases being unsuccessful.
Undercorrection occurred in 3 patients, and overcorrection in 2.
Abduction limitation showed slight improvement in 29.41% of cases; one patient with a 7mm recession experienced secondary adduction limitation.

Conclusions:

Moderate horizontal rectus recession is a generally simple and effective surgical option for Duane syndrome when secondary duction limitations are absent.
The procedure offers only marginal improvement in abduction for a subset of patients.