Unilateral large lateral rectus recession in treatment of unilateral exotropic duane retraction syndrome

Abstract

Purpose The purpose of this study was to determine the effect of unilateral large lateral rectus (LR) recession on head turn and horizontal ocular deviation in patients with unilateral exotropic Duane retraction syndrome. Patients and methods This was a prospective, interventional study of 10 consecutive patients with unilateral exotropic Duane retraction syndrome associated with contralateral head turn. All patients underwent large (8.5–10 mm) unilateral LR recession on the affected eye. All patients were followed up for at least 6 months. Preoperative and postoperative ocular deviation, angle of head turn, stereoacuity, and severity of limitation in abduction and adduction were recorded and analyzed. Results Mean head turn decreased from 30.5±9.56° (range, 15°–40°) to 6.5±4.74° (range, 0°–15°) (P<0.001). Mean exotropia decreased from 33.0±6.32 prism diopter (range, 25–45 prism diopter) to 5.7±4.9 prism diopter (range, 0–15 prism diopter) (P<0.001). Mean limitation in adduction decreased from ‒2.8±0.79 to ‒1.6±0.52 (P<0.001). Mean limitation in abduction increased from ‒3.0±1.16 to ‒3.6±0.7 (P=0.024). All patients had variable degrees of stereopsis (ranging between 100 and 800 arcsec, which remain unchanged postoperatively). Conclusion Unilateral large LR recession abolishes or ameliorates the wide scale of head turn and exotropia in unilateral exotropic Duane retraction syndrome with noticeable improvement of defective adduction