Unilateral rectus muscle recession in the treatment of Duane syndrome

PURPOSE To determine the outcome of unilateral single horizontal rectus recession surgery in patients with Duane retraction syndrome. METHODS A retrospective review was conducted of 27 medical records of patients with Duane syndrome who underwent unilateral medial rectus recession for esodeviations and lateral rectus recession for exodeviations. The criteria for evaluating surgical success included improvement of abnormal head position, reduction of strabismus deviation, and preservation or improvement of stereoacuity. RESULTS Patients had an average recession of 6.3 mm and were followed for an average of 4 years. Of the 27 patients treated with unilateral horizontal rectus muscle recession, 93% had a postoperative head turn of <10 degrees in primary position and 85% an ocular deviation of <10(Delta). An excellent outcome, defined as a combination of stereoacuity of <100 arcsec, head turn <10 degrees, and strabismus of <10(Delta), was achieved by 63% of patients. CONCLUSIONS Unilateral single horizontal rectus muscle recession improves or eliminates head turn, corrects strabismus in primary position of gaze, and maintains good stereoacuity in a majority of patients with Duane syndrome. (J AAPOS 2012;16:145-149)