The authors present the results of two surgical approaches to treat exotropia Duane’s retraction syndrome (DRS) with significant overshoot and retraction. This study compared single Y-split recession of the lateral rectus muscle vs combined Y-split lateral rectus recession plus medial rectus recession. Twenty-one patients were included: 10 male. All had unilateral type III DRS with left eye involvement in 18 cases. Primary position exotropia measured 8–20PD; mean 15.23PD. Face turn measured 10–25 degrees. Mean age at surgery was 15.38 years. The single surgery group (13 cases) had better average exotropia correction (15.76PD) vs combined surgery (11.12PD) plus better mean face turn correction (18.46 degrees) than combined surgery (12.12 degrees). Combined surgery had better mean correction of overshoot and retraction (grades 2.63 and 2.50) vs single surgery (grades 2.31 and 1.92). Overall, both surgical approaches gave successful correction of deviation angle, face turn and vertical movements. However, where vertical movement abnormalities are the main concern, combined surgery appeared to provide more benefit.
Single vs combined y-split surgery for Duane’s type III
Reviewed by Fiona Rowe
Y-split recession of lateral rectus with and without medial rectus recession in the management of exotropic Duane’s Retraction Syndrome with significant overshoot and retraction.
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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