Infosan Eye Clinic, Romania
Title: Reoperations in Duane retraction syndrome
Biography: Andreea Ciubotaru
Introduction: Patients with strabismus who have undergone previous eye muscle surgery often present a challenge to strabismus surgeons, especially in restrictive strabismus cases like Duane’s retraction syndrome (DRS). Even has been a recognized clinical entity for nearly a century, DRS is sometime mistaken for essential infantile esotropia or abducens paralysis. <br>
Methods: We retrospectively evaluated 15 patients undergoing surgery for esotropia 4 to 22 years ago in other eye clinics. All patients were referred to us for the misalignment in primary position and abnormal head position. After the previous operation, nine patients developed a consecutive exotropia (group 1) and six of them were still esotropic in primary position (group 2). Angle
of strabismus in primary position, head posture, abduction and adduction of the affected eye were measured before and after surgery in our clinic. Photos from childhood were reviewed and the diagnosis for all was DRS. <br>
Results: 12 patients have first heard about DRS. In group 1, the intraoperative findings showed a previous medial rectus recession (in the affected eye) in six cases and a contralateral medial rectus recession (in the normal eye) in three cases. The mean deviation in primary position decreased from 28 prism diopters (PD) exotropia preoperatively to eight PD exotropia postoperatively. In group 2, the intraoperative findings showed in the affected eye a previous medial rectus recession in three cases and lateral rectus resection in three cases. The mean deviation in primary position decreased after reoperation from 25 PD esotropia preoperatively to 10 PD esotropia postoperatively. All patients improved their abnormal head posture after reoperation. <br>
Conclusion: Although the clinical findings and the surgical approach in Duane’s retraction syndrome are very clear, in medical practice from Romania we meet even today misinterpreted forms of DRS requiring reoperation.