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Turkish Journal of Ophthalmology Aug 2015To present the outcomes of modified lateral rectus Y-splitting combined with either unilateral or bilateral horizontal rectus recession in Duane Retraction Syndrome...
OBJECTIVES
To present the outcomes of modified lateral rectus Y-splitting combined with either unilateral or bilateral horizontal rectus recession in Duane Retraction Syndrome (DRS) with significant upshoot or downshoot.
MATERIALS AND METHODS
A total of 12 patients including 10 patients with Type I DRS and 2 with Type III DRS underwent modified Y-splitting surgery. Amount of additional recessions varied with the degree of preoperative deviation by intraoperative adjustable suture technique. Preoperatively 3 patients had esotropia (ET), 6 had exotropia (XT), and 3 patients had orthotropia. The mean preoperative deviation was 19.3 prism diopters (PD) (range, 18-20 PD) in ET patients and 19.2 PD (range, 16-20 PD) in XT patients.
RESULTS
Postoperatively, all patients had significant correction in horizontal deviation and aligned within 4 PD of orthotropia, and no patients exhibited abnormal head posture. Co-contraction and globe retraction were markedly reduced and abnormal ocular vertical movement disappeared or significantly decreased in all cases. No patients experienced recurrence of ocular motility disorders in the mean 26-month (range, 13-66 months) follow-up period.
CONCLUSION
Modified Y-splitting surgery combined with co-contracting horizontal muscle recession technique seems to be a safe and effective treatment in DRS.
PubMed: 27800223
DOI: 10.4274/tjo.70188 -
Middle East African Journal of... 2015Managing a case of incomitant strabismus from nerve palsy or extraocular muscle loss is a major challenge. Among possible management options are globe or extraocular... (Review)
Review
Managing a case of incomitant strabismus from nerve palsy or extraocular muscle loss is a major challenge. Among possible management options are globe or extraocular muscle fixation to the orbital wall coupled with weakening or strengthening of the relevant antagonist. Extraocular muscle fixation to the orbital wall can also be used in cases of abnormal synkinesis to eliminate the abnormal eye movements of a misfiring extraocular muscle, which thereby allows the use of standard paralytic strabismus surgery techniques. This review article summarizes indications and techniques of periosteal fixation procedures for incomitant strabismus.
Topics: Duane Retraction Syndrome; Humans; Oculomotor Muscles; Oculomotor Nerve Diseases; Ophthalmologic Surgical Procedures; Ophthalmoplegia; Strabismus
PubMed: 26180470
DOI: 10.4103/0974-9233.159736 -
Indian Journal of Ophthalmology May 2015
Topics: Accommodation, Ocular; Duane Retraction Syndrome; Esotropia; Eye Movements; Female; Humans; Male; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Vision, Binocular
PubMed: 26139819
DOI: 10.4103/0301-4738.159908 -
Prilozi (Makedonska Akademija Na... 2015Wildervanck syndrome (WS) combines features of Klippel-Feil syndrome (KFS), sixth nerve palsy, and deafness. This is a case of a 23 year old woman, diagnosed with KFS (a...
Wildervanck syndrome (WS) combines features of Klippel-Feil syndrome (KFS), sixth nerve palsy, and deafness. This is a case of a 23 year old woman, diagnosed with KFS (a triad of short neck, low posterior hairline and restricted neck movements) at the age of 20 days. The manifestations of the WS in this patient are severe: she has torticollis, and an extremely severe scoliosis. In addition, she is short (-3 SD; parental target height + 0.8SD) and has mixed sensorineural and conductive deafness. She also has ptosis, strabismus and a high myopia. Radiologically, there are multiple coalitions of cervical vertebrae. Intelligence is unaffected (IQ 95), but deafness, strabismus and high myopia forced her early out of school. Karyotype is 46, XX. In brief, this is a patient with severe WS and additional anomalies. Short and/or reduced parental target height is a part of WS.
Topics: Abducens Nerve Diseases; Abnormalities, Multiple; Deafness; Duane Retraction Syndrome; Female; Growth Disorders; Heart Defects, Congenital; Heart Septal Defects, Atrial; Humans; Klippel-Feil Syndrome; Lower Extremity Deformities, Congenital; Scoliosis; Severity of Illness Index; Torticollis; Upper Extremity Deformities, Congenital; Young Adult
PubMed: 26076792
DOI: 10.1515/prilozi-2015-0047 -
Indian Journal of Ophthalmology Mar 2015
Topics: Duane Retraction Syndrome; Esotropia; Female; Humans; Male; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Vision, Binocular
PubMed: 25971189
DOI: 10.4103/0301-4738.156970 -
Indian Journal of Ophthalmology Mar 2015
Topics: Duane Retraction Syndrome; Esotropia; Female; Humans; Male; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Vision, Binocular
PubMed: 25971188
DOI: 10.4103/0301-4738.156965 -
The Pan African Medical Journal 2014We report a case of a four year old Nigerian girl who presented to the paediatric unit of our eye clinic with complaints of a squint on looking to the right side and...
We report a case of a four year old Nigerian girl who presented to the paediatric unit of our eye clinic with complaints of a squint on looking to the right side and reduction in the size of the right eye when looking to the left. On examination, she had right exotropia in the primary position of gaze. There was limitation of abduction and widening of the palpebral fissure of the right eye on right gaze. On left gaze there was narrowing of the palpebral fissure of the right eye with marked limitation of adduction and an upshoot, or occasionally a downshoot, of the eyeball. This report demonstrates that Duane's syndrome occurs in West Africa. Therefore, detailed examination of all patients with squints is important to ensure accurate diagnosis and appropriate management of the patient's condition.
Topics: Child, Preschool; Duane Retraction Syndrome; Exotropia; Female; Humans
PubMed: 25722769
DOI: 10.11604/pamj.2014.19.96.4641 -
Eye (London, England) Jun 2015
Topics: Abducens Nerve Diseases; Duane Retraction Syndrome; Female; Humans; Male; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Suture Techniques; Tendon Transfer
PubMed: 25657043
DOI: 10.1038/eye.2014.309 -
Eye (London, England) Jun 2015
Topics: Abducens Nerve Diseases; Duane Retraction Syndrome; Female; Humans; Male; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Suture Techniques; Tendon Transfer
PubMed: 25657042
DOI: 10.1038/eye.2014.310 -
Eye (London, England) Feb 2015We review ocular motor cranial nerve palsies in childhood and highlight many of the features that differentiate these from their occurrence in adulthood. The clinical... (Review)
Review
We review ocular motor cranial nerve palsies in childhood and highlight many of the features that differentiate these from their occurrence in adulthood. The clinical characteristics of cranial nerve palsies in childhood are affected by the child's impressive ability to repair and regenerate after injury. Thus, aberrant regeneration is very common after congenital III palsy; Duane syndrome, the result of early repair after congenital VI palsy, is invariably associated with retraction of the globe in adduction related to the innervation of the lateral rectus by the III nerve causing co-contraction in adduction. Clinical features that may be of concern in adulthood may not be relevant in childhood; whereas the presence of mydriasis in III palsy suggests a compressive aetiology in adults, this is not the case in children. However, the frequency of associated CNS abnormalities in III palsy and the risk of tumour in VI palsy can be indications for early neuroimaging depending on presenting features elicited through a careful history and clinical examination. The latter should include the neighbouring cranial nerves. We discuss the impact of our evolving knowledge of congenital cranial dysinnervation syndromes on this field.
Topics: Abducens Nerve; Abducens Nerve Diseases; Child; Child, Preschool; Eye Diseases; Humans; Nerve Regeneration; Oculomotor Nerve; Oculomotor Nerve Diseases; Trochlear Nerve; Trochlear Nerve Diseases
PubMed: 25572578
DOI: 10.1038/eye.2014.292