The authors aimed to compare the safety and efficacy of augmented superior rectus transposition surgery with / without medial rectus (MR) recession versus MR recession along in the treatment of esotropic DRS. This was a prospective randomised trial of 20 patients with esotropia type 1 DRS. Groups 1 (10 cases) underwent superior rectus (SR) transposition of which eight also had MR recession. Group 2 (10 cases) underwent MR recession only. Group 1 included five males and five females aged 13.65 ±7.7 years. Group 2 included three males and seven females aged 8.7 ±6.325 years. The left eye was affected in 80 and 70% respectively. Postoperatively, group 1 had 90% orthotropia and 10% residual esotropia. Group 2 had 80% orthotropia and 20% residual esotropia. There were no over corrections or complications. The deviation angle reduced from 20.4 ±2.75 and 22.5 ±2.635PD preop for groups 1 and 2 to 0.6 ±1.897 and 0.9 ±1.911PD postop respectively. There was no difference between groups for deviation angle or for improvement in abnormal head posture. Change in abduction was significant with greater improvement in group 1. However, surgery for group 1 could be complicated by induced vertical deviation as acknowledged by the authors. The authors recognise the limits of their small sample size and further studies are required.
Esotropia Duane’s syndrome (DRS) surgery
Reviewed by Fiona Rowe
Superior rectus transposition with medial rectus recession, versus medial rectus recession, in esotropia Duane’s retraction syndrome.
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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