Surgical and functional outcomes in bilateral exotropic Duane's retraction syndrome

Abstract

Surgery for bilateral exotropic DRS resulted in an improvement in the primary position angle and abnormal head posture. Patients demonstrated reduced cumulative horizontal ocular ductions restrictions and enhanced near-stereovision. This case series on exotropic bilateral DRS provides further evidence into successful postoperative surgical and functional outcomes.

Modified Y-splitting Procedure for the Treatment of Duane Retraction Syndrome

“…Extraocular muscle surgery does not eliminate the abnormality of muscle innervation and no surgical technique can successfully restore normal ocular movement, as we observed in our cases. 2,3,4,7,8 …”

“…Therefore, to prevent refusion in this patient, a modified Y-splitting procedure was developed in which non-absorbable separation sutures were placed around the two halves without scleral fixation. 3 Another 11 patients underwent modified Y-splitting in their initial operation. We did not observe any recurrence during the follow-up period of up to 66 months, which to our knowledge is the longest regular follow-up period of the Y-splitting procedure.…”

“…In modified Y-splitting, in addition to the standard procedure described above, non-absorbable separation sutures were placed around the split parts of each half without scleral fixation in order to prevent reproliferation and refusion of the middle split. 3 …”

“…That misdirection causes paradoxical contraction of LR during adduction, meaning Hering’s Law does not apply to DRS. 1,2,3,4,5,6 …”

Transposition procedures in Duane retraction syndrome

“…It can be associated with type 1, 2, or 3 DS and even with different types in each eye. 55 Surgical planning in these cases must be tailored to a given clinical scenario. We are not aware of any reported transposition procedure outcomes for this form of DS.…”