This study reports the use of bilateral lateral rectus (LR) recessions instead of unilateral LR recession for unilateral exotropic Duane’s retraction syndrome (DRS) with abnormal head posture. This was a retrospective study of seven patients; five female and two male. Follow-up was a minimum of one month (mean 282 days) in this retrospective study. Mean age was 14.9 years. The average LR recession was 6.36mm. Mean exotropia angle measurement of the secondary angle in primary gaze was 27.86±5.7PD reducing to 7.86±16.8PD postoperatively. The secondary deviation was measured to reveal the maximum motor deviation. One patient required a second procedure for persistent exotropia and abnormal head posture. The abnormal head posture resolved in all cases at final follow-up. There was one case of overcorrection, which resolved within one week of surgery. By dividing the surgery, the authors propose they avoid increased abduction deficit but acknowledge the limitations of this small retrospective study.

The efficacy of bilateral lateral rectus recession according to secondary deviation measurement in unilateral exotropic Duane’s retraction syndrome.
Mezad-Koursh D, Leshno A, Klein A, Stolovich C.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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