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Lateral Rectus Disabling and Simultaneous Modified Nishida Procedure for Exotropic Duane Retraction Syndrome.

Karthikeyan Arcot Sadagopan^1,2,3,4, Nithya Raghunandan², Neha Satish Saswade²

¹Pediatric Ophthalmology & Ocular Genetics, C-MER (Shenzhen) Dennis Lam Eye Hospital, Shenzhen, China.

Journal of Binocular Vision and Ocular Motility

|July 22, 2024

Summary

This summary is machine-generated.

This study presents a surgical technique combining lateral rectus muscle disinsertion and periosteal fixation with the modified Nishida procedure for Exotropic-Duane Syndrome (XT-DRS). The combined approach successfully reduced key symptoms and improved convergence in patients with this congenital disorder.

Keywords:

Duane retraction syndrome Y split recession exotropia globe retraction lateral rectus disinsertion and periosteal fixation modified Nishida procedure palpebral fissure narrowing

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Area of Science:

Ophthalmology
Neurology
Pediatric Surgery

Background:

Exotropic-Duane Syndrome (XT-DRS) is a congenital disorder affecting cranial nerve innervation.
XT-DRS presents with exotropia, anomalous head posture, limited adduction, and globe retraction.
Poor convergence is common in XT-DRS due to anomalous lateral rectus muscle innervation.

Observation:

Two patients with XT-DRS underwent simultaneous lateral rectus muscle disinsertion and periosteal fixation (LRDAPF) and modified Nishida procedure (MNP).
One patient also received a contralateral lateral rectus recession.
Surgical outcomes were evaluated for symptom reduction and convergence improvement.

Findings:

The combined surgical approach led to a reduction in anomalous head posture, exotropia, globe retraction, and palpebral fissure narrowing.
Abnormal eye movements, including upshoot and downshoot in adduction, were also diminished.
Both patients demonstrated improved convergence after the surgical intervention.

Implications:

This surgical technique offers a potential treatment for Exotropic-Duane Syndrome, addressing multiple characteristic symptoms.
Improved convergence may enhance binocular function and visual outcomes for patients.
Further research can explore the long-term efficacy and applicability of this combined surgical approach.