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The efficacy of asymmetric bilateral medial rectus muscle recession surgery in unilateral, esotropic, type 1 Duane syndrome.
MedLine Citation:
PMID:  23237751     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Many patients with esotropic, type 1 Duane syndrome adopt a head turn to gain binocular vision. Numerous surgical procedures have been performed to correct this condition, including asymmetric bilateral medial rectus muscle recession, first proposed by Jampolsky. However, few publications reported on the efficacy of this procedure.
METHODS: The medical records of patients with unilateral, esotropic Duane syndrome who had asymmetric medial rectus muscle recession for correction of their abnormal head turn were retrospectively reviewed with attention to head turn, ductions, and motor alignment at near and distance fixation. Surgery was considered successful when preoperative head turn was completely eliminated.
RESULTS: A total of 28 patients (18 females; mean age, 8 years) were included. In 24 patients (86%), the left eye was involved. Medial rectus recession averaged 4.7 mm (range, 3.25-6.0 mm) in the affected eye, with a recession larger by 1.0 mm in the unaffected eye. Average esotropia in the forced primary position improved from 32(Δ) preoperatively to 6(Δ) postoperatively, with a mean 22° improvement in head position (24°-2°). Twenty-four patients (86%) achieved complete resolution of their head turn postoperatively; the other 4 patients experienced partial improvement, with a residual head turn of 10°; a second re-recession of the medial rectus muscle in the affected eye of 1 patient resulted in complete resolution of head turn.
CONCLUSIONS: Our study showed that asymmetric bilateral medial rectus recession eliminated the head turn in most of our patients with unilateral esotropic Duane syndrome.
Authors:
Gad Dotan; Ainat Klein; Noa Ela-Dalman; Shiri Shulman; Chaim Stolovitch
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus     Volume:  16     ISSN:  1528-3933     ISO Abbreviation:  J AAPOS     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9710011     Medline TA:  J AAPOS     Country:  United States    
Other Details:
Languages:  eng     Pagination:  543-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Ophthalmology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: gaddotan@hotmail.com.
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