Document Detail

Isolated y-splitting and recession of the lateral rectus muscle in patients with exo-duane syndrome.
MedLine Citation:
PMID:  22906380     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Weakening of both horizontal rectus muscles is performed for patients with Duane syndrome and significant misinnervation of the lateral rectus (LR) muscle resulting in strabismus, limitation to ocular rotations, and globe retraction. In patients with severe up-/downshoots, a Y-splitting of the LR is often recommended. The purpose of this study was to evaluate the efficacy of isolated unilateral LR recession-Y splitting in exo-Duane patients with limitation to adduction and up-/downshoots.
METHODS: etrospective review of the records of consecutive patients with exo-Duane syndrome and up/down-shoots who underwent isolated Y-splitting-recession of the affected LR.
RESULTS: The records of 10 patients were reviewed (mean age at surgery 23 ± 21 years). The Y-split was performed 10 mm posterior to the insertion and was combined with a mean LR recession of 8.7 ± 2.9 mm. Torticollis decreased from 12.7 ± 4.4° to 4.8 ± 5.3° (P = 0.003). Exotropia improved from 18.4 ± 7.3 to 6.2 ± 5.9 PD postoperatively (P < 0.001). Exotropia in contralateral gaze improved from 33.7 ± 11.8 to 18.7 ± 18.1 PD postoperatively (P = 0.09). No significant postoperative changes in esotropia in ipsilateral gaze, vertical deviations, or ocular rotations in adduction or abduction were observed. Downshoots were significantly decreased (P = 0.01), and there was a trend toward improvement of upshoots (P = 0.07). There were no overcorrections, although 3 patients required additional LR weakening and transposition.
CONCLUSIONS: LR Y-splitting-recession improves ocular alignment, torticollis, and up-/downshoots. LR recession improves ocular alignment and torticollis, while the addition of a Y-split procedure improves up-/downshoots.
Federico G Velez; Guillermo Velez; Karen Hendler; Stacy L Pineles
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Strabismus     Volume:  20     ISSN:  1744-5132     ISO Abbreviation:  Strabismus     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-21     Completed Date:  2013-02-19     Revised Date:  2013-07-22    
Medline Journal Info:
Nlm Unique ID:  9310896     Medline TA:  Strabismus     Country:  England    
Other Details:
Languages:  eng     Pagination:  109-14     Citation Subset:  IM    
Jules Stein Eye Institute, University of California Los Angeles, CA 90095, USA.
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MeSH Terms
Duane Retraction Syndrome / complications,  physiopathology,  surgery*
Esotropia / complications,  physiopathology,  surgery*
Follow-Up Studies
Middle Aged
Oculomotor Muscles / surgery*
Ophthalmologic Surgical Procedures / methods*
Postoperative Period
Retrospective Studies
Treatment Outcome
Vision, Binocular / physiology*
Young Adult
Grant Support
Comment In:
Strabismus. 2013 Mar;21(1):1-2   [PMID:  23477768 ]
Strabismus. 2013 Mar;21(1):3   [PMID:  23477769 ]

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