Surgical Results in DRS: Customised approach

Jaspreet Sukhija

PURPOSE: To study the outcome of surgery in patients with Duane retraction syndrome (DRS).

METHODS: Thirteen patients with DRS were analyzed. Indication for surgery was strabismus, upshoot-downshoot, abnormal head position, and globe retraction. In 7 cases with exotropia, the lateral rectus muscle was recessed from 10 to 15 mm mm combined with "Y-split" according to deviation in primary position. In 3 patients who had esotropia with face turn, a medial rectus recession of 6 mm was performed. Bilateral medial rectus recession of 4 to 6 mm was done in 3 cases with bilateral DRS.

RESULTS: Six out of seven cases that underwent LR recession with Y split had complete elimination of face turn with marked reduction in downshoot-upshoot. Globe retraction decreased considerably and the patients were orthotropic. In one case where the face turn was more than 30 degrees, a residual face turn did persist after surgery. Patients with unilateral esotropic DRS were orthotropic after surgery with no face turn. In all patients with bilateral DRS orthotropia was achieved.

CONCLUSION: Surgical management in DRS should be customized based on the clinical presentation. Successful outcome is possible in most of these cases.