ABSTRACT
ABSTRACT: Purpose: The purpose of this study is to present our results in treating the upshoot or downshoot of Duane’s retraction syndrome in particular with splitting of the lateral rectus into a Y configuration at its insertion. Methods: Six patients (4 male, 2 female) from our practice at Hacettepe University Hospitals, Ankara were included in this study. Subjects ranged in age from 3 to 21 at the time of surgery and follow up was from ten months to seven years. Three patients showed the motility characteristics of type 2 Duanes retraction syndrome, two patients type 3 and one patient had abduction deficit of the right eye and both abduction and adduction deficit of the left eye. All patients demonstrated a variable face turn and an upshoot was present in all patients. They underwent motility surgery to eliminate the overshoot and the face turn. Results: The right eye was affected in two patients, left eye in two and the other two patients had bilateral involvement. All of them had deviation in the primary position (range: 12-60 pd, mean: 33.67 pd). The method of surgery to treat the upshoot was splitting of the lateral rectus muscle into a Y configuration in five patients and lateral rectus recession only in one patient. To relieve the deviation in primary position, lateral rectus recessions were performed in all patients. The splitting of the ends of the lateral rectus into a Y configuration resulted in improvement of the upshoot in all patients without any complications. Lateral rectus recession only had no effect on the upshoot. Conclusion: The splitting of the ends of the lateral rectus into a Y configuration is an easily performed operation which effectively improves the upshoot in patients with Duanes’ retraction syndrome. Performing simultaneous recession to the lateral rectus muscle combined with the splitting into Y configuration improves the outcome, especially in patients with marked globe retraction.
