title: Comparison of augmented superior rectus transposition with medial rectus recession for surgical management of esotropic Duane retraction syndrome.
abstract: BACKGROUND
  Medial rectus recession (MRc) and vertical rectus transpositions are procedures used to treat esotropic Duane retraction syndrome. Recently superior rectus transposition (SRT) combined with MRc has also been shown to improve primary alignment and abduction. The purpose of this study is to compare the results of augmented (ie, with scleral fixation) SRT with or without MRc with either unilateral or bilateral MRc for treatment of esotropic Duane syndrome.
  
  
  METHODS
  The medical records of patients who underwent surgery for esotropic Duane syndrome between May 2007 and February 2013 were retrospectively reviewed. Success was defined as alignment within 8(Δ) of orthotropia and abnormal head posture of <5°.
  
  
  RESULTS
  There were 8 patients in the SRT group (6 of whom had additional ipsilateral MRc) and 13 in the MRc group (6 unilateral and 7 bilateral). In the SRT group, the mean preoperative deviation was 20(Δ) of esotropia; the mean postoperative deviation, 3(Δ). In the MRc group, the mean preoperative deviation was 24(Δ) of esotropia; the mean postoperative deviation, 4(Δ). The success rate was 87% in the SRT group; 77%, in MRc group (P = 0.98). Mean abduction limitation improved from -3.6 to -2.4 units in the SRT group and from -3.6 to -3.3 units in the MRc group (P = 0.003). Induced vertical deviation or subjective torsion was not seen. Three patients in each group developed adduction limitation postoperatively.
  
  
  CONCLUSIONS
  Although both the procedures successfully correct esotropia in Duane syndrome, SRT with or without MRc has the additional advantage of improving abduction.
authors.affiliation: Department of Pediatric Ophthalmology and Strabismus, Dr. Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India.
authors.forename: Shailja
authors.initials: S
authors.lastname: Tibrewal
authors.affiliation: Nimmagada Prasad Children's Eye Care Centre, GMRV Campus, L V Prasad Eye Institute, Visakhapatnam, Andhra Pradesh, India.
authors.forename: Virender
authors.initials: V
authors.lastname: Sachdeva
authors.affiliation: Center for Clinical Epidemiology and Bio-statistics (CCEB), KAR Campus, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India.
authors.forename: Mohammed Hasnat
authors.initials: MH
authors.lastname: Ali
authors.affiliation: Jasti V Ramanamma Children's Eye Care Centre, KAR Campus, L V Prasad Eye Institute, Hyderabad, India. Electronic address: rameshak@lvpei.org.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Kekunnaya
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004370:Duane Retraction Syndrome / Q000503:physiopathology / Q000601:surgery*; D004948:Esotropia / Q000503:physiopathology / Q000601:surgery*; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000637:transplantation*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D011187:Posture; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013709:Tendon Transfer; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult