نماي باليني و نتايج جراحي در مبتلايان به سندرم دوين در بيمارستان لبافي نژاد

Clinical Features and Results of Surgery for Duaneʹs Retraction Syndrome

Purpose: To report clinical features, types, and results of surgery for Duaneʹs retraction syndrome (DRS). Methods: This is an existing data study on the records of patients with DRS. The study was conducted on the hospital records of patients who were referred for DRS to a tertiacy eye center in Tehran, Iran during 8 years. The follow-up period after the surgery was at least 6 months. Results: Data of 42 cases was studied. Mean age was 11.7 years (14 months to 25 years). Twenty-seven cases (64%) were female and 15 cases (36%) were male. The involved eye was left in 24 (57%), right in I3 (31%), and both eyes in 5 cases (12%). Ocular alignment in primary position was esotropia in 20 (47.5%), exotropia in 14 (33.5%), and orthotropia in 8 cases (19%). The most common type of DRS was type I (57%) followed by type II (31%) and type 111 (9%). There was one case (3%) of synergistic divergence. Shooting phenomen was present in 17 (41%) patients. Ocular abnormalities were present in 16% and systemic abnormalities in 7%. Thirty-three cases (78.5%) underwent operation. Indications of surgery were ocular deviation (79%), abnormal head posture (51.5%), palpebral fissure changes and retraction (51.5%), and shooting (27%). The operation was performed on one or two horizontal rectus muscles in 63% and on three or four muscles in 39%. Type of surgery was bimedial rectus recession and bilateral rectus recession in 63%, vertical muscles transposition in 27%, and splitting of the lateral rectus in 24%. In 61% of patients the affected eye improved with one operation. Abnormal head posture was improved in 76%. Cases with residual deviation, abnormal head posture, vertical deviation, or shooting phenomena were re-operated. Conclusion: DRS can be diagnosed clinically most of the times; signs and symptoms can be significantly improved with appropriately tailored operation on extraocular muscles.