Title: Superior rectus recession for vertical deviation and A pattern of type III Duane retraction syndrome

Yonghong Jiao

INTRODUCTION: To report the results of superior rectus recession for vertical deviation and A pattern in Duane retraction syndrome (DRS) Type III and discuss the pathogenesis of the disease.

METHODS: Superior and lateral rectus recession were performed in 5 cases of Huber type III DRS to treat vertical deviation and A pattern strabismus. MRI of the brain including brainstem, cavernous sinus, and orbits were performed preoperatively.

RESULTS: The abducens nerves (CN6) were either absent or hypoplastic in the brainstems and the orbits of all the patients. MRI showed hypoplasia of the superior rectus and inferior rectus in the affected side in two patients. After surgery, vertical deviation in the primary position was reduced in all patients and A pattern was eliminated in 3 patients. One patient developed 10△ consecutive esotropia postoperatively.

DISCUSSION：Vertical muscle abnormalities are related to vertical deviation and the presence of A pattern in DRS type III.

CONCLUSION: Recession of the superior rectus muscle is a safe and effective treatment for vertical deviation and A pattern strabismus in DRS Type III.