Recession of both horizontal rectus muscles in Duane Retraction Syndrome with significant globe retraction
- Author:
- No author available
- Journal Title:
- Chinese Journal of Ophthalmology
- Issue:
- 9
- DOI:
- 10.3760/cma.j.issn.0412-4081.2012.09.004
- Key Word:
- Duane眼球后退综合征;眼外科手术;动眼肌;Duane retraction syndrome;Ophthalmologic surgical procedures;Oculomotor muscles
Abstract： Objective To evaluate the effect of Recession of both horizontal rectus muscles in Duane Retraction Syndrome with significant globe retraction.Methods Sixteen cases with DRS were summarized retrospectively.All patients bad undergone surgery with recession of both horizontal rectus muscles.All clinical records,including sex,age,types of DRS,clinical features,surgical methods and clinical outcomes were analyzed.All patients were followed up for 3 months to 1 year.Results Fifteen cases had only monocular involvement while one had both eyes.The number of type Ⅰ DRS was 3 cases,1 case was esotropia while others were orthotropia in primary position.Type Ⅲ DRS was observed 13 cases.Esotropia was seen in 6 cases (7 eyes),exotropia of 1 cases and orthotropia in primary position of 6 cases.10 cases exhibited marked face turn.An upshoot or downshoot and variable severity of retraction of globe were found in all patients on attempt adduction of the affected eye.All patients had undergone surgery with recession of both horizontal rectus muscles.The medical rectus muscles were recessed from 5 mm to 7 mm and lateral rectus muscles 3 mm to 9 mm simultaneously,which was based on the amount of primary position deviation.Among these 2 cases were combined with Y-splitting of lateral rectus muscle.After surgery,all patients were orthotropia in primary position. Their symptom of unacceptable abnormal head position,significant globe retraction,noticeable narrowing of the palpebral fissure and significant upshoot or downshoot were ameliorated or disappeared.Especially the recession of lateral rectus muscle in addition to Y-splitting combining with the simultaneous medial rectus recession resulted in further amelioration of globe retraction in addition to upshoot and downshoot.Conclusion Recession of both horizontal rectus muscles is effective in the treatment of significant globe retraction in Duane syndrome. Type Ⅲ DRS with significant globe retraction but has no marked deviation and face turn can adopt this method to ameliorate their aspect.The method of lateral rectus muscle in addition to Y-splitting plays an important role in the treatment of upshoot and downshoot.
- [1]Zhenchang W,Kanxing Z,Yonghong J.Detailed magnetic resonance imaging findings of the ocular motor nerves in Duane's retraction syndrome.[J].2009,46(5).
- [2]麦光焕.现代斜视治疗学[M].1999.
- [3]A Huber.Electrophysiology of the retraction syndromes.[J].1974,58(3).
- [4]Helveston EM,Rao VB,Sahare P.Treatment of upshoot and downshoot in Duane syndrome by recession and Y-splitting of the lateral rectus muscle.[J].2003,7(6).
- [5]Duane Alexander.Congenital Deficiency of Abduction, Associated With Impairment of Adduction, Retraction Movements, Contraction of the Palpebral Fissure and Oblique Movements of the Eye[J].1996.
- [6]Evans JC,Gutowski NJ,Frayling TM,etc.Confirmation of linkage of Duane's syndrome and refinement of the disease locus to an 8.8-cM interval on chromosome 2q31.[J].2000,106(6).
- [7]D T, Sprunger.Recession of both horizontal rectus muscles in Duane syndrome with globe retraction in primary position.[J].1997,1(1).
- [8]VenkateshwarRao,B.,Ray,D.,Vashist,U.,etc.Duane retraction syndrome: Series of 441 cases[J].2012,49(3).
- [9]Simsek S,Arifoglu HB,Altintas AG,etc.Clinical findings and surgical results of Duane retraction syndrome.[J].2010,47(4).
- [10]Engle EC,Demer JL,Lim KH,etc.Magnetic resonance imaging evidence for widespread orbital dysinnervation in dominant Duane's retraction syndrome linked to the DURS2 locus.[J].2007,48(1).
- [11]P A, DeRespinis,A R, Caputo,R S, Wagner,etc.Duane's retraction syndrome.[J].1900,38.