Poor results after recession of both medial rectus muscles in unilateral small-angle Duane's syndrome, type I.
OBJECTIVE
To eliminate an abnormal face turn in unilateral Duane's syndrome, type I, the medial rectus muscle of the Duane's eye is commonly recessed. Additional recession of the normal contralateral medial rectus muscle has been advocated in selected cases, although little has been published regarding this technique. We present poor results in a small consecutive series.


METHODS
Four consecutive cases of unilateral Duane's syndrome, type I, with small-angle primary position esotropia are retrospectively reviewed with attention to postoperative face turn. In all cases, the medial rectus muscle of the "normal" eye was recessed as was the medial rectus muscle of the Duane's eye.


RESULTS
Two subjects showed little to no improvement in face turn; one subject developed an increased turn; and the last subject developed a consecutive exotropia.


CONCLUSIONS
In small-angle Duane's syndrome, type I, recession of the normal medial rectus may decrease the positive effects of recessing the Duane's medial rectus muscle with respect to face turn as well as increase the risk of consecutive exotropia. An alternate theory of normal-eye Duane's surgery is proposed.
Eye Consultants of Atlanta, Scottish Rite Children's Medical Center, Atlanta, GA, USA.
Marc F
MF
Greenberg
Zane F
ZF
Pollard
D000328:Adult; D002675:Child, Preschool; D004370:Duane Retraction Syndrome / Q000503:physiopathology / Q000601:surgery*; D005099:Exotropia / Q000209:etiology; D005145:Face; D005260:Female; D006257:Head / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects; D011187:Posture; D012189:Retrospective Studies; D017211:Treatment Failure