The authors report the surgical outcomes of patients with exotropic Duane’s retraction syndrome (DRS) in a retrospective study of 73 patients; 67 unilateral cases. Patients had a mean age at surgery of 14.11 years (range 2-33). The left eye was affected in 69% and the right in 37.3%. There were 38 males and 35 females. None of the cases had amblyopia. Type 3 was the most common (77%) followed by type 1 (19%) and type 2 (1.3%). Two patients had synergistic divergence on adduction. The main indication for surgery was abnormal head posture in primary gaze (90%). Overshoots in adduction were present in 71%, and 37% had globe retraction. Unilateral lateral rectus recession was undertaken for 65% and bilateral recessions for 34%. Five patients had both medial and lateral recti recessions to address co-contraction. Y splitting of the lateral rectus for overshoots was undertaken in 56%. Exotropia in primary gaze was 23 ±14.04PD reducing to 9 ±8.7PD postoperatively. Mean follow-up was 22.5 weeks (range 8-209). At last follow-up, 40% were orthotropic with surgical success rate of 74%. Abnormal head posture reduced to <5 degrees in 82%. Reduced overshoots were in 71% and 44% of these disappeared completely. Reoperation was needed for 19% because of residual exotropia and overshoots. All were type 3 with larger preoperative exotropia (mean 34PD). The authors conclude good outcomes generally but surgery must be decided on individual characteristics.
Surgical outcome reporting for exotropic DRS
Reviewed by Fiona Rowe
Surgical outcomes of exotropic Duane’s retraction syndrome from a tertiary eye care center.
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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