title: Contralateral lateral rectus muscle recession in patients with Duane retraction syndrome type 3.
abstract: OBJECTIVE
  The aim of this study was to evaluate the motor, sensory, functional, and head posture results of recession of the lateral rectus muscle contralateral to the involved eye in patients with exotropic Duane retraction syndrome (DRS) type 3.
  
  
  METHODS
  This was a retrospective, longitudinal, observational study of a consecutive clinical case series. Of the 11 patients with DRS type 3 operated on at a tertiary medical center from 1977 to 2012, 8 underwent recession of the lateral rectus muscle contralateral to the involved eye (with combined Y-splitting of ipsilateral lateral rectus muscle in 3 of them). Full ophthalmic, orthoptic, and neurological examination was performed before and after surgery. Main outcome measures included intragroup changes in motor misalignment, abnormal head turn, ocular upshoot, and stereopsis.
  
  
  RESULTS
  Mean patient age was 8.75±3.1 years at surgery. Mean exodeviation for distance was -17.3±3.5 prism diopters (PD) preoperatively and -4.0±6.1 PD postoperatively; corresponding values for near were -23.1±7.2 PD and -5.9±8.7 PD. Motor deviation improved by 77% for distance (P=0.017) and 74.5% for near (P=0.01). In 7/8 patients, the postoperative residual exodeviation (distance and near) was <8.0 PD. There was an 80% improvement in head turn, from 15.3±4° before surgery to 3.1±5.0° after (P=0.01). Stereopsis improved significantly in 6/8 patients. Findings remained stable during follow-up (mean duration 35.9±50.8 months, range 5-132 months).
  
  
  CONCLUSIONS
  Contralateral lateral rectus muscle recession appears to be a promising technique for the treatment of moderate unilateral DRS type 3, with patients showing significant motor and functional improvement and a decrease in head turn.
authors: 1] Pediatric Ophthalmology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel [2] Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel [3] Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: M
authors: M
authors: Snir
authors: Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel.
authors: A
authors: A
authors: Dotan
authors: 1] Pediatric Ophthalmology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel [2] Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: R
authors: R
authors: Friling
authors: Pediatric Ophthalmology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
authors: Y
authors: Y
authors: Ron-Kella
authors: 1] Pediatric Ophthalmology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel [2] Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: N
authors: N
authors: Goldenberg-Cohen
authors: 1] Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel [2] Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel [3] Neuro-Ophthalmology Unit, Rabin Medical Center, Petach Tikva, Israel.
authors: H
authors: H
authors: Stiebel-Kalish
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003867:Depth Perception / Q000502:physiology; D004370:Duane Retraction Syndrome / Q000503:physiopathology / Q000601:surgery*; D005099:Exotropia / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006257:Head / Q000502:physiology; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D011187:Posture; D012189:Retrospective Studies; D055815:Young Adult