Effect of lateral rectus muscle resection on abduction in Duane retraction syndrome type 1

Purpose To assess the effect of lateral rectus muscle resection on abduction in Duane retraction syndrome (DRS) type 1. Methods The medical records of patients with DRS type 1 were reviewed retrospectively. Fifteen patients who underwent lateral rectus resection were included. Prism and cover test and the Krimsky test were used to detect deviations. Ocular ductions, abnormal head position (AHP), and globe retraction were recorded. Results Nine (60.0%) patients were female. The mean age was 13.1 +/- 2.3 (range, 2-34) years. Left eyes were included in ten (66.7%) patients. Mean follow-up time was 37.6 +/- 16.6 (range, 6-70) months. All patients had AHP, 13 patients had mild globe retraction, and 2 patients had no globe retraction preoperatively. Mean lateral rectus resection was 3.1 +/- 0.7 (range, 2.0-4.5) mm, and the mean medial rectus recession was 4.4 +/- 0.6 (range, 3.0-5.0) mm. The mean preoperative deviation decreased from 23.3 +/- 6.9 (range, 14-35) prism diopters (pd) to 2.2 +/- 4.1 (range, 0-10) pd at near, and from 23.6 +/- 7.1 (range, 14-35) pd to 1.8 +/- 3.5 (range, 0-10) pd at distance, at 6 months postoperatively (p = 0.01). The mean limitation in abduction decreased from - 3.2 +/- 0.9 to - 1.3 +/- 1.1 postoperatively (p < 0.001). AHP resolved in all patients. There was not a limitation in adduction or a worsening of globe retraction in any patient. Conclusion Lateral rectus resection can be used to improve abduction in patients with DRS type 1 who have mild globe retraction. We assume that this procedure has no worsening effect on globe retraction in appropriate cases.