title: Vertical muscle transposition augmented with lateral fixation (Foster) suture for Duane syndrome and sixth nerve palsy.
abstract: OBJECTIVE
  To report the postoperative results of full-tendon vertical rectus transposition (VRT) augmented with lateral fixation suture for the treatment of type 1 Duane syndrome and sixth nerve palsy and to determine whether there was a decrease in the effect of the Foster suture over time.
  
  
  METHODS
  This retrospective, consecutive case series included patients who underwent a full-tendon VRT transposition with lateral fixation for type 1 Duane syndrome or sixth nerve palsy. The primary outcome measures included deviation, abnormal head posture(AHP), abduction deficiency, and postoperative binocular single visual field (BSVF).
  
  
  RESULTS
  Eighty-seven patients (87 eyes: 40 eyes with Duane syndrome and 47 eyes with sixth nerve palsy) were included in this study. In Duane syndrome patients, the deviation was reduced by a mean of 95%, the AHP was eliminated in 86% of patients, the abduction was improved by 42%, and a useful BSVF of ≈ 67% of normal was achieved at 1 year post operation. In sixth nerve palsy patients, the deviation was reduced by 99%, the abduction was improved by 59%, and a useful BSVF of ≈ 71% of normal was achieved at 1 year post operation. In both groups, the improvements in deviation angle and abduction were stable postoperatively. Sixteen patients needed reoperation for undercorrection.
  
  
  CONCLUSIONS
  VRT surgery with posterior fixation is an effective treatment method for complete sixth nerve palsy and Duane syndrome with esotropia, AHP, and abduction deficiency. The procedure carries a small risk of reoperation for undercorrection. The effect of the Foster suture did not decline over time.
authors.affiliation: Pediatric Ophthalmology and Strabismus Department, Professor Dr N. Reşat Belger Beyoglu Education and Research Eye Hospital, Istanbul, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Akar
authors.forename: B
authors.initials: B
authors.lastname: Gokyigit
authors.forename: G
authors.initials: G
authors.lastname: Pekel
authors.forename: A
authors.initials: A
authors.lastname: Demircan
authors.forename: A
authors.initials: A
authors.lastname: Demirok
mesh_terms: D020434:Abducens Nerve Diseases / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004370:Duane Retraction Syndrome / Q000601:surgery*; D004948:Esotropia / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D013536:Suture Techniques; D013709:Tendon Transfer / Q000379:methods*; D055815:Young Adult
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