Duane Retraction Syndrome: Clinical characteristics and Surgical Approach in 691 patients at a single pediatric ophthalmology center
Babak Masoomian1 *, Mohammad Reza Akbari2 , Arash MIrmohammad Sadeghi2
- Farabi eye hospital, Tehran university of medical sciences
- Farabi eye Hospital, Tehran university of medical sciences
Abstract: To evaluate the clinical findings and surgical approach in different types of Duane Retraction Syndrome (DRS)
Methods: This retrospective study was performed on 691 patients with DRS in which managed successfully with surgery in Farabi Eye Hospital from January 2010 to December 2020
Results: The mean age of DRS patients was 16.7 ± 12.5 (range, 1.0 -73) years. The patient’s records included 396 (57.3%) females and 295 (42.7%) males (P<0.001). DRS type I, II, III and IV were observed in 429 (62.1%), 168 (24.3%), 88 (12.7%) and 6 (0.9%) patients, respectively. Unilateral DRS was observed in 628 (90.9%) patients, of whom the left eye was affected in 471 (%78.9) and the right eye in 157 (21.1%) cases (P<.001). Other clinical findings were overshoots (n=236, 34.2%), AHP (n=522, 78.1%) and amblyopia (n=118, 17.1%). The prevalence of overshoots in type I, II and III was 17.5% (75/429), 60.7% (102/168) and 64.8% (57/88), respectively (P<0.001). Amblyopia was detected significantly more in patients with AHP (80/522, 15.3%) compared to patients without AHP (38/169, 22.5%) (P=0.023). The mean angle of deviation in primary position at far for esotropic group was 21.7± 11.5 PD and for exotropic group was 17.8± 12.4 PD. The most common type of first surgery was medial rectus recession performed for 264 (27.5%) patients. The second surgery was performed for 62 (9.0%) patients (almost 1.1 surgery for each patient). Amblyopia (30.6% vs 15.7%, p=0.013) and mean angle of deviation in primary position (27.7±11.5 vs 19.0±10.5 PD, p=0.019) were significantly more in cases who need more than one surgery.
Conclusion: The most common type of DRS was type I followed by type II and type III, respectively. One third of total patients had overshoots, 2/3 of patients had AHP and 17% of patients had amblyopia. Each patient needs 1.1 surgery to reach the acceptance result.
