Full vertical rectus muscle transposition combined with medial posterior fixation sutures for patients with adduction deficiency.
OBJECTIVE
To compare the surgical and functional results of full tendon rectus muscle transposition to the medial rectus muscle augmented with posterior medial fixation sutures in patients with adduction deficiency (ADD) and Duane's syndrome type 2.


METHODS
Retrospective nonconcurrent interventional comparative case series.


METHODS
Twelve consecutive patients with ADD and Duane's syndrome type 2.


METHODS
Six patients treated by the full tendon rectus muscle transposition procedure alone were compared with 6 patients treated by the full tendon rectus muscle transposition combined with posterior medial fixation sutures.


METHODS
Postoperative ocular alignment, duction improvement, binocular functions, and reoperation.


RESULTS
In the augmented surgery group, mean distance and near deviation decreased by 74.5% and 74%, respectively, versus 56% and 59%, respectively, in the control group (P = 0.007 and 0.02, between-group comparison for distance and near deviation, respectively). Mean duction improved in 73% of the study group compared with 52% of controls (P = 0.025). No postoperative complications or duction anomalies were observed during follow-up in the entire cohort; reoperation was needed in 1 patient in the study group and in all 6 patients in the control group.


CONCLUSIONS
The augmented full vertical rectus muscle procedure is a beneficial surgical approach for patients with ADD and Duane's retraction syndrome type 2, reducing the need for multiple extraocular muscle surgery.
Snir
Moshe
M
Pediatric Ophthalmology Unit, Schneider Children's Medical Center of Israel, Tel Aviv, Israel. moshesnir@hotmail.com
Friling
Ronit
R
Kalish-Stiebel
Hadas
H
Sherf
Ilana
I
Weinberger
Dov
D
Axer-Siegel
Ruth
R
D020434:Abducens Nerve Diseases / Q000503:physiopathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002648:Child; D004370:Duane Retraction Syndrome / Q000503:physiopathology / Q000601:surgery*; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000637:transplantation*; D013508:Ophthalmologic Surgical Procedures; D012086:Reoperation; D012189:Retrospective Studies; D013536:Suture Techniques; D013709:Tendon Transfer / Q000379:methods*; D015348:Vision, Binocular / Q000502:physiology