Evaluation of periosteal fixation of lateral rectus and partial VRT for cases of exotropic Duane retraction syndrome.
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Date
2014-02
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Abstract
Purpose: The purpose of this study is to evaluate the lateral rectus periosteal fixation and partial
vertical rectus transpositioning (VRT) as treatment modalities to correct exotropic Duane retraction
syndrome (Exo‑DRS). Materials and Methods: Prospective interventional case study of cases of Exo‑DRS
with limitation of adduction. A total of 13 patients were subdivided into two groups. Six patients
underwent only lateral rectus periosteal fixation (group A) and seven patients also underwent partial
VRT (group B). Assessment involved prism bar cover test, abduction and adduction range, extent of
binocular single visual field and exophthalmometry. These tests were repeated at 1 week, 1 month and
3 months post‑operatively and data analyzed. Results: The pre‑operative mean values and ranges were
26.2 Δ (22‑35) exotropia for group A and −21.3 Δ (14‑30) exotropia for group B. The post‑operative mean and
range was +0.6 Δ esotropia (+20 to −8) for group A and 8 Δ (−2 to −20) exotropia for group B. Mean grade
of limitation of abduction changed from −3.8 to −3.6 versus −3.6 to −2.8 and mean grade of limitation of
adduction changed from −1.9 to −0.7 versus −1.5 to −0.5 in the groups A and B respectively. Mean binocular
single visual field changed from 14.7° to 23.3° in group A and 11.8° to 26.4° in the group B respectively.
Conclusion: Lateral rectus periosteal fixation is an effective surgery to correct the exodeviation, anomalous
head posture and improving adduction in Exo‑DRS and partial VRT in addition is effective in improving
abduction and binocular single visual fields.
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Keywords
Exotropic Duane retraction syndrome, periosteal fixation, strabismus surgery, vertical rectus transposition
Citation
Sharma Pradeep, Tomer Ruchi, Menon Vimla, Saxena Rohit, Sharma Anudeepa. Evaluation of periosteal fixation of lateral rectus and partial VRT for cases of exotropic Duane retraction syndrome. Indian Journal of Ophthalmology. 2014 Feb ; 62 (2): 204-208.