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Mohammadreza Akbari - One of the best experts on this subject based on the ideXlab platform.
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superior rectus transposition and medial rectus recession for treatment of Duane Retraction Syndrome and sixth nerve palsy
Journal of binocular vision and ocular motility, 2021Co-Authors: Mohammadreza Akbari, Ahmad Masoumi, Arash MirmohammadsadeghiAbstract:Purpose: To evaluate the outcome of augmented superior rectus transposition (SRT) with medial rectus (MR) recession in patients with Duane Retraction Syndrome (DRS) and sixth nerve palsy.Methods: Twenty four patients (16 DRS and 8 sixth nerve palsy) that underwent the procedure were included. The superior rectus muscle was secured, detached, and re-attached to the sclera along the spiral of Tilaux, adjacent to lateral rectus insertion. A non-absorbable augmentation suture was passed through the sclera, 8 mm posterior to the insertion of the lateral rectus.Results: At the last follow-up, the effect of surgery in decreasing esotropia in both groups was significant (P = .001 for DRS group, P = .002 for sixth nerve palsy). In both groups, abduction deficit improved significantly (P < .001 for DRS and P = .008 for sixth nerve palsy). After the surgery, small, asymptomatic vertical deviation in primary position was induced in five patients (20.8%). Post-operatively, none of the patients complained of torsional diplopia. In the 6-month follow-up, compared with the first postoperative visit, an eso-drift at distance or near developed in 11 patients (45.8%). Of the 11 patients with eso-drift, overcorrection (exotropia of 3-14 PD) was present at the first post-operative visit in 5 cases. Four cases showed an exo-drift (2-5 PD) at distance or near over time.Conclusion: SRT with medial rectus recession improves esotropia and abduction limitation without inducing significant vertical deviations and torsional diplopia. Some of the cases that underwent SRT with MR recession may show an eso-drift. The eso-drift can correct initial exotropia in some cases.
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surgical outcome of patients with unilateral exotropic Duane Retraction Syndrome
Journal of Aapos, 2020Co-Authors: Mohammadreza Akbari, Arash Mirmohammadsadeghi, Ahmad Masoumi, Babak Masoomian, Mohammad MehrpourAbstract:Abstract Purpose To describe the clinical features and surgical outcomes of patients with unilateral exotropic Duane Retraction Syndrome (DRS). Methods The medical records of patients with unilateral exotropic DRS who underwent surgery between March 2015 and February 2018 were reviewed retrospectively. Results A total of 40 patients (mean age, 18.75 ± 12.54 years; 21 males [53%]) were included. In 28 patients (70%) the left eye was involved. All patients had globe Retraction and head turn toward the opposite side of the affected eye. Remarkable upshoot/downshoot movement was detectable in 11 patients (28%). The mean deviation for near and distance improved from 24.37Δ ± 12.34Δ (range, 6Δ-77Δ) and 19.67 ± 10.76Δ (range, 4Δ-60Δ) to 4.25Δ ± 8.61Δ (range, 0Δ-50Δ) and 2.62Δ ± 6.15Δ (range, 0Δ-35Δ) after the first surgery (P Conclusions Simple lateral rectus recession (with or without Y-splitting), even in the presence of significant deviation (through 35Δ), seems to be a successful procedure for management of patients with unilateral exotropic DRS.
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Augmented superior rectus transposition procedure in Duane Retraction Syndrome compared with sixth nerve palsy
Graefe's Archive for Clinical and Experimental Ophthalmology, 2018Co-Authors: Mohammadreza Akbari, Setareh Shomali, Arash Mirmohammadsadeghi, Masoud Aghsaei FardAbstract:Purpose Superior rectus transposition (SRT) with medial rectus recession has been used for the treatment of sixth nerve palsy and esotropic Duane Retraction Syndrome (DRS). The purpose of this study was to compare the results of augmented SRT (with scleral fixation) without medial rectus recession in DRS and sixth nerve palsy. Methods Patients with unilateral esotropic DRS (DRS group) and sixth nerve palsy were included in this prospective, comparative study and underwent SRT. Preoperative forced duction testing was negative or slightly positive in both groups. Prospective measurements were compared between the two groups. Results There were 11 patients in the DRS group and 11 patients in the sixth nerve palsy group. The mean preoperative esotropia decreased from 20.9 ± 6.0 prism diopter (PD) at far to 13.2 ± 5.8 PD in the DRS group ( P = 0.003). The same measurement improved from 28.0 ± 8.5 PD to 8.4 ± 7.3 PD in the sixth nerve palsy group ( P = 0.003). In the sixth nerve palsy group, the improvement in primary gaze esotropia and abnormal head posture was more than the DRS group (Both P
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Augmented superior rectus transposition procedure in Duane Retraction Syndrome compared with sixth nerve palsy.
Graefes Archive for Clinical and Experimental Ophthalmology, 2018Co-Authors: Mohammadreza Akbari, Setareh Shomali, Arash Mirmohammadsadeghi, Masoud Aghsaei FardAbstract:Superior rectus transposition (SRT) with medial rectus recession has been used for the treatment of sixth nerve palsy and esotropic Duane Retraction Syndrome (DRS). The purpose of this study was to compare the results of augmented SRT (with scleral fixation) without medial rectus recession in DRS and sixth nerve palsy. Patients with unilateral esotropic DRS (DRS group) and sixth nerve palsy were included in this prospective, comparative study and underwent SRT. Preoperative forced duction testing was negative or slightly positive in both groups. Prospective measurements were compared between the two groups. There were 11 patients in the DRS group and 11 patients in the sixth nerve palsy group. The mean preoperative esotropia decreased from 20.9 ± 6.0 prism diopter (PD) at far to 13.2 ± 5.8 PD in the DRS group (P = 0.003). The same measurement improved from 28.0 ± 8.5 PD to 8.4 ± 7.3 PD in the sixth nerve palsy group (P = 0.003). In the sixth nerve palsy group, the improvement in primary gaze esotropia and abnormal head posture was more than the DRS group (Both P
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augmented superior rectus transposition procedure in Duane Retraction Syndrome compared with sixth nerve palsy
Graefes Archive for Clinical and Experimental Ophthalmology, 2018Co-Authors: Mohammadreza Akbari, Setareh Shomali, Arash Mirmohammadsadeghi, Masoud Aghsaei FardAbstract:Superior rectus transposition (SRT) with medial rectus recession has been used for the treatment of sixth nerve palsy and esotropic Duane Retraction Syndrome (DRS). The purpose of this study was to compare the results of augmented SRT (with scleral fixation) without medial rectus recession in DRS and sixth nerve palsy. Patients with unilateral esotropic DRS (DRS group) and sixth nerve palsy were included in this prospective, comparative study and underwent SRT. Preoperative forced duction testing was negative or slightly positive in both groups. Prospective measurements were compared between the two groups. There were 11 patients in the DRS group and 11 patients in the sixth nerve palsy group. The mean preoperative esotropia decreased from 20.9 ± 6.0 prism diopter (PD) at far to 13.2 ± 5.8 PD in the DRS group (P = 0.003). The same measurement improved from 28.0 ± 8.5 PD to 8.4 ± 7.3 PD in the sixth nerve palsy group (P = 0.003). In the sixth nerve palsy group, the improvement in primary gaze esotropia and abnormal head posture was more than the DRS group (Both P < 0.001).The average dose effect for SRT was 7.8 ± 2.2 PD in the DRS group and 19.2 ± 4.6 PD in the sixth nerve palsy group. Although objective intorsion was significantly induced after SRT, subjective torsion was not significant after surgery in both groups. SRT appears to be more effective in improving primary gaze deviation and head posture in sixth nerve palsy compared with DRS. Subjective torsional and vertical diplopia were rare in both groups.
Masoud Aghsaei Fard - One of the best experts on this subject based on the ideXlab platform.
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Augmented superior rectus transposition procedure in Duane Retraction Syndrome compared with sixth nerve palsy
Graefe's Archive for Clinical and Experimental Ophthalmology, 2018Co-Authors: Mohammadreza Akbari, Setareh Shomali, Arash Mirmohammadsadeghi, Masoud Aghsaei FardAbstract:Purpose Superior rectus transposition (SRT) with medial rectus recession has been used for the treatment of sixth nerve palsy and esotropic Duane Retraction Syndrome (DRS). The purpose of this study was to compare the results of augmented SRT (with scleral fixation) without medial rectus recession in DRS and sixth nerve palsy. Methods Patients with unilateral esotropic DRS (DRS group) and sixth nerve palsy were included in this prospective, comparative study and underwent SRT. Preoperative forced duction testing was negative or slightly positive in both groups. Prospective measurements were compared between the two groups. Results There were 11 patients in the DRS group and 11 patients in the sixth nerve palsy group. The mean preoperative esotropia decreased from 20.9 ± 6.0 prism diopter (PD) at far to 13.2 ± 5.8 PD in the DRS group ( P = 0.003). The same measurement improved from 28.0 ± 8.5 PD to 8.4 ± 7.3 PD in the sixth nerve palsy group ( P = 0.003). In the sixth nerve palsy group, the improvement in primary gaze esotropia and abnormal head posture was more than the DRS group (Both P
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Augmented superior rectus transposition procedure in Duane Retraction Syndrome compared with sixth nerve palsy.
Graefes Archive for Clinical and Experimental Ophthalmology, 2018Co-Authors: Mohammadreza Akbari, Setareh Shomali, Arash Mirmohammadsadeghi, Masoud Aghsaei FardAbstract:Superior rectus transposition (SRT) with medial rectus recession has been used for the treatment of sixth nerve palsy and esotropic Duane Retraction Syndrome (DRS). The purpose of this study was to compare the results of augmented SRT (with scleral fixation) without medial rectus recession in DRS and sixth nerve palsy. Patients with unilateral esotropic DRS (DRS group) and sixth nerve palsy were included in this prospective, comparative study and underwent SRT. Preoperative forced duction testing was negative or slightly positive in both groups. Prospective measurements were compared between the two groups. There were 11 patients in the DRS group and 11 patients in the sixth nerve palsy group. The mean preoperative esotropia decreased from 20.9 ± 6.0 prism diopter (PD) at far to 13.2 ± 5.8 PD in the DRS group (P = 0.003). The same measurement improved from 28.0 ± 8.5 PD to 8.4 ± 7.3 PD in the sixth nerve palsy group (P = 0.003). In the sixth nerve palsy group, the improvement in primary gaze esotropia and abnormal head posture was more than the DRS group (Both P
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augmented superior rectus transposition procedure in Duane Retraction Syndrome compared with sixth nerve palsy
Graefes Archive for Clinical and Experimental Ophthalmology, 2018Co-Authors: Mohammadreza Akbari, Setareh Shomali, Arash Mirmohammadsadeghi, Masoud Aghsaei FardAbstract:Superior rectus transposition (SRT) with medial rectus recession has been used for the treatment of sixth nerve palsy and esotropic Duane Retraction Syndrome (DRS). The purpose of this study was to compare the results of augmented SRT (with scleral fixation) without medial rectus recession in DRS and sixth nerve palsy. Patients with unilateral esotropic DRS (DRS group) and sixth nerve palsy were included in this prospective, comparative study and underwent SRT. Preoperative forced duction testing was negative or slightly positive in both groups. Prospective measurements were compared between the two groups. There were 11 patients in the DRS group and 11 patients in the sixth nerve palsy group. The mean preoperative esotropia decreased from 20.9 ± 6.0 prism diopter (PD) at far to 13.2 ± 5.8 PD in the DRS group (P = 0.003). The same measurement improved from 28.0 ± 8.5 PD to 8.4 ± 7.3 PD in the sixth nerve palsy group (P = 0.003). In the sixth nerve palsy group, the improvement in primary gaze esotropia and abnormal head posture was more than the DRS group (Both P < 0.001).The average dose effect for SRT was 7.8 ± 2.2 PD in the DRS group and 19.2 ± 4.6 PD in the sixth nerve palsy group. Although objective intorsion was significantly induced after SRT, subjective torsion was not significant after surgery in both groups. SRT appears to be more effective in improving primary gaze deviation and head posture in sixth nerve palsy compared with DRS. Subjective torsional and vertical diplopia were rare in both groups.
Ramesh Kekunnaya - One of the best experts on this subject based on the ideXlab platform.
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Duane—minus (Duane sine Retraction and Duane sine limitation): possible incomplete forms of Duane Retraction Syndrome
Eye, 2020Co-Authors: Ahmed Awadein, Shaimaa A Arfeen, Pratik Chougule, Ramesh KekunnayaAbstract:Purpose To report ocular motility patterns that mimic, but do not fulfil the full clinical picture of Duane Retraction Syndrome (DRS) and to describe their clinical features and surgical management. Methods This is a retrospective case series study conducted on patients with DRS, mimicking non-comitant exotropia or esotropia and a face turn. Patients were included only if they lacked either globe Retraction on adduction (sine Retraction) or limitation of adduction or abduction on ductions (sine limitation not >0.5). Any overshoots or pattern strabismus was recorded. The ocular motility and alignment, details of surgery and their surgical outcomes were analysed. Results Twenty-one patients were identified; 13 in the sine Retraction and 8 in the sine limitation group. All patients presented with a compensatory face turn. Overshoots were present in 10 (77%) and 7 patients (88%) in the sine Retraction and sine limitation groups, respectively. Forced duction test showed tightness of the ipsilateral medial and the ipsilateral lateral rectus muscle in esotropic ( n = 3) and exotropic patients ( n = 18), respectively. Orthotropia was achieved in 82% of patients following ipsilateral medial or lateral rectus muscle recession. Conclusions There is a subset of patients who present with motility pattern similar to DRS but lack its complete diagnostic criteria. The presence of a face turn, overshoots on adduction or an ipsilateral tightness of the affected muscle should make one consider DRS sine Retraction/sine limitation. The patients in our study responded well to lines of management similar to those of DRS.
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Duane minus Duane sine Retraction and Duane sine limitation possible incomplete forms of Duane Retraction Syndrome
Eye, 2020Co-Authors: Ahmed Awadein, Shaimaa A Arfeen, Pratik Chougule, Ramesh KekunnayaAbstract:To report ocular motility patterns that mimic, but do not fulfil the full clinical picture of Duane Retraction Syndrome (DRS) and to describe their clinical features and surgical management. This is a retrospective case series study conducted on patients with DRS, mimicking non-comitant exotropia or esotropia and a face turn. Patients were included only if they lacked either globe Retraction on adduction (sine Retraction) or limitation of adduction or abduction on ductions (sine limitation not >0.5). Any overshoots or pattern strabismus was recorded. The ocular motility and alignment, details of surgery and their surgical outcomes were analysed. Twenty-one patients were identified; 13 in the sine Retraction and 8 in the sine limitation group. All patients presented with a compensatory face turn. Overshoots were present in 10 (77%) and 7 patients (88%) in the sine Retraction and sine limitation groups, respectively. Forced duction test showed tightness of the ipsilateral medial and the ipsilateral lateral rectus muscle in esotropic (n = 3) and exotropic patients (n = 18), respectively. Orthotropia was achieved in 82% of patients following ipsilateral medial or lateral rectus muscle recession. There is a subset of patients who present with motility pattern similar to DRS but lack its complete diagnostic criteria. The presence of a face turn, overshoots on adduction or an ipsilateral tightness of the affected muscle should make one consider DRS sine Retraction/sine limitation. The patients in our study responded well to lines of management similar to those of DRS.
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Duane Retraction Syndrome causes effects and management strategies
Clinical Ophthalmology, 2017Co-Authors: Ramesh Kekunnaya, Mithila NegalurAbstract:Duane Retraction Syndrome (DRS) is a congenital eye movement anomaly characterized by variable horizontal duction deficits, with narrowing of the palpebral fissure and globe Retraction on attempted adduction, occasionally accompanied by upshoot or down-shoot. The etiopathogenesis of this condition can be explained by a spectrum of mechanical, innervational, neurologic and genetic abnormalities occurring independently or which influence each other giving rise to patterns of clinical presentations along with a complex set of ocular and systemic anomalies. Huber type I DRS is the most common form of DRS with an earlier presentation, while Huber type II is the least common presentation. Usually, patients with unilateral type I Duane Syndrome have esotropia more frequently than exotropia, those with type II have exotropia and those with type III have esotropia and exotropia occurring equally common. Cases of bilateral DRS may have variable presentation depending upon the type of presentation in each eye. As regards its management, DRS classification based on primary position deviation as esotropic, exotropic or orthotropic is more relevant than Huber's classification before planning surgery. Surgical approach to these patients is challenging and must be individualized based on the amount of ocular deviation, abnormal head position, associated globe Retraction and overshoots.
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a high prevalence of exotropia in patients with Duane Retraction Syndrome in a tertiary eye care center in south india
Journal of Pediatric Ophthalmology & Strabismus, 2017Co-Authors: Manjushree Bhate, Virender Sachdeva, Ramesh KekunnayaAbstract:Purpose To determine the prevalence and clinical characteristics of patients with Duane Retraction Syndrome presenting with exotropia in a tertiary eye care center. Methods Medical records of 140 patients with Duane Retraction Syndrome and exotropia (of the total 441 patients with Duane Retraction Syndrome) seen from 2000 to 2009 were reviewed. Characteristics studied included age at presentation, gender, laterality, manifest primary position, abnormal head posture, ocular motility, and overshoots. Data were collected regarding associated ocular or systemic abnormalities and amblyopia. Results The mean age of the patients at presentation was 16.96 ± 15.09 years (range: 1 to 70 years). Of the 140 patients with Duane Retraction Syndrome and exotropia, 59 (42%) were male. Unilateral type I Duane Retraction Syndrome accounted for 118 (84.2%), type II for 7 (5%), and type III for 10 (7.1%) patients, whereas 5 (3.6%) had Duane Retraction Syndrome and bilateral exotropia. Duane Retraction Syndrome was seen in the left eye, right eye, and both eyes in 97 (69%), 37 (26%), and 6 (4%) patients, respectively. Exotropia ranged from 10 to 60 prism diopters. An abnormal head posture was noted in 101 (72%) and upshoot in 26 (18.6%) patients. Reported ocular and systemic abnormalities in these patients included cataract (6), aniridia (1), nasolacrimal duct block (1), and retinal breaks (1). Conclusions This is an exclusive study on a large series of patients with Duane Retraction Syndrome and exotropia. Almost one-third of patients with Duane Retraction Syndrome patients might have exotropia. Although patients with Duane Retraction Syndrome and exotropia had clinical characteristics and associations similar to those with Duane Retraction Syndrome and esotropia, there was an increased propensity for overshoots and face turn opposite to the affected eye, which the authors hypothesize to be due to a tight or short lateral rectus muscle. [J Pediatr Ophthalmol Strabismus. 2017;54(2):117-122.].
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a simple and novel grading method for Retraction and overshoot in Duane Retraction Syndrome
British Journal of Ophthalmology, 2016Co-Authors: Ramesh Kekunnaya, Ruby Moharana, Shailja Tibrewal, Preetipatil Chhablani, Virender SachdevaAbstract:Strabismus in Duane Retraction Syndrome is frequently associated with significant globe Retraction and overshoots. However, there is no method to objectively grade Retraction and overshoot. Our purpose is to describe a novel objective grading method. This novel and simple grading method has excellent agreement. It will help standardise measurements and guide the clinician in taking the decision for surgery and predicting its outcome.
Arash Mirmohammadsadeghi - One of the best experts on this subject based on the ideXlab platform.
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superior rectus transposition and medial rectus recession for treatment of Duane Retraction Syndrome and sixth nerve palsy
Journal of binocular vision and ocular motility, 2021Co-Authors: Mohammadreza Akbari, Ahmad Masoumi, Arash MirmohammadsadeghiAbstract:Purpose: To evaluate the outcome of augmented superior rectus transposition (SRT) with medial rectus (MR) recession in patients with Duane Retraction Syndrome (DRS) and sixth nerve palsy.Methods: Twenty four patients (16 DRS and 8 sixth nerve palsy) that underwent the procedure were included. The superior rectus muscle was secured, detached, and re-attached to the sclera along the spiral of Tilaux, adjacent to lateral rectus insertion. A non-absorbable augmentation suture was passed through the sclera, 8 mm posterior to the insertion of the lateral rectus.Results: At the last follow-up, the effect of surgery in decreasing esotropia in both groups was significant (P = .001 for DRS group, P = .002 for sixth nerve palsy). In both groups, abduction deficit improved significantly (P < .001 for DRS and P = .008 for sixth nerve palsy). After the surgery, small, asymptomatic vertical deviation in primary position was induced in five patients (20.8%). Post-operatively, none of the patients complained of torsional diplopia. In the 6-month follow-up, compared with the first postoperative visit, an eso-drift at distance or near developed in 11 patients (45.8%). Of the 11 patients with eso-drift, overcorrection (exotropia of 3-14 PD) was present at the first post-operative visit in 5 cases. Four cases showed an exo-drift (2-5 PD) at distance or near over time.Conclusion: SRT with medial rectus recession improves esotropia and abduction limitation without inducing significant vertical deviations and torsional diplopia. Some of the cases that underwent SRT with MR recession may show an eso-drift. The eso-drift can correct initial exotropia in some cases.
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surgical outcome of patients with unilateral exotropic Duane Retraction Syndrome
Journal of Aapos, 2020Co-Authors: Mohammadreza Akbari, Arash Mirmohammadsadeghi, Ahmad Masoumi, Babak Masoomian, Mohammad MehrpourAbstract:Abstract Purpose To describe the clinical features and surgical outcomes of patients with unilateral exotropic Duane Retraction Syndrome (DRS). Methods The medical records of patients with unilateral exotropic DRS who underwent surgery between March 2015 and February 2018 were reviewed retrospectively. Results A total of 40 patients (mean age, 18.75 ± 12.54 years; 21 males [53%]) were included. In 28 patients (70%) the left eye was involved. All patients had globe Retraction and head turn toward the opposite side of the affected eye. Remarkable upshoot/downshoot movement was detectable in 11 patients (28%). The mean deviation for near and distance improved from 24.37Δ ± 12.34Δ (range, 6Δ-77Δ) and 19.67 ± 10.76Δ (range, 4Δ-60Δ) to 4.25Δ ± 8.61Δ (range, 0Δ-50Δ) and 2.62Δ ± 6.15Δ (range, 0Δ-35Δ) after the first surgery (P Conclusions Simple lateral rectus recession (with or without Y-splitting), even in the presence of significant deviation (through 35Δ), seems to be a successful procedure for management of patients with unilateral exotropic DRS.
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Augmented superior rectus transposition procedure in Duane Retraction Syndrome compared with sixth nerve palsy
Graefe's Archive for Clinical and Experimental Ophthalmology, 2018Co-Authors: Mohammadreza Akbari, Setareh Shomali, Arash Mirmohammadsadeghi, Masoud Aghsaei FardAbstract:Purpose Superior rectus transposition (SRT) with medial rectus recession has been used for the treatment of sixth nerve palsy and esotropic Duane Retraction Syndrome (DRS). The purpose of this study was to compare the results of augmented SRT (with scleral fixation) without medial rectus recession in DRS and sixth nerve palsy. Methods Patients with unilateral esotropic DRS (DRS group) and sixth nerve palsy were included in this prospective, comparative study and underwent SRT. Preoperative forced duction testing was negative or slightly positive in both groups. Prospective measurements were compared between the two groups. Results There were 11 patients in the DRS group and 11 patients in the sixth nerve palsy group. The mean preoperative esotropia decreased from 20.9 ± 6.0 prism diopter (PD) at far to 13.2 ± 5.8 PD in the DRS group ( P = 0.003). The same measurement improved from 28.0 ± 8.5 PD to 8.4 ± 7.3 PD in the sixth nerve palsy group ( P = 0.003). In the sixth nerve palsy group, the improvement in primary gaze esotropia and abnormal head posture was more than the DRS group (Both P
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Augmented superior rectus transposition procedure in Duane Retraction Syndrome compared with sixth nerve palsy.
Graefes Archive for Clinical and Experimental Ophthalmology, 2018Co-Authors: Mohammadreza Akbari, Setareh Shomali, Arash Mirmohammadsadeghi, Masoud Aghsaei FardAbstract:Superior rectus transposition (SRT) with medial rectus recession has been used for the treatment of sixth nerve palsy and esotropic Duane Retraction Syndrome (DRS). The purpose of this study was to compare the results of augmented SRT (with scleral fixation) without medial rectus recession in DRS and sixth nerve palsy. Patients with unilateral esotropic DRS (DRS group) and sixth nerve palsy were included in this prospective, comparative study and underwent SRT. Preoperative forced duction testing was negative or slightly positive in both groups. Prospective measurements were compared between the two groups. There were 11 patients in the DRS group and 11 patients in the sixth nerve palsy group. The mean preoperative esotropia decreased from 20.9 ± 6.0 prism diopter (PD) at far to 13.2 ± 5.8 PD in the DRS group (P = 0.003). The same measurement improved from 28.0 ± 8.5 PD to 8.4 ± 7.3 PD in the sixth nerve palsy group (P = 0.003). In the sixth nerve palsy group, the improvement in primary gaze esotropia and abnormal head posture was more than the DRS group (Both P
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augmented superior rectus transposition procedure in Duane Retraction Syndrome compared with sixth nerve palsy
Graefes Archive for Clinical and Experimental Ophthalmology, 2018Co-Authors: Mohammadreza Akbari, Setareh Shomali, Arash Mirmohammadsadeghi, Masoud Aghsaei FardAbstract:Superior rectus transposition (SRT) with medial rectus recession has been used for the treatment of sixth nerve palsy and esotropic Duane Retraction Syndrome (DRS). The purpose of this study was to compare the results of augmented SRT (with scleral fixation) without medial rectus recession in DRS and sixth nerve palsy. Patients with unilateral esotropic DRS (DRS group) and sixth nerve palsy were included in this prospective, comparative study and underwent SRT. Preoperative forced duction testing was negative or slightly positive in both groups. Prospective measurements were compared between the two groups. There were 11 patients in the DRS group and 11 patients in the sixth nerve palsy group. The mean preoperative esotropia decreased from 20.9 ± 6.0 prism diopter (PD) at far to 13.2 ± 5.8 PD in the DRS group (P = 0.003). The same measurement improved from 28.0 ± 8.5 PD to 8.4 ± 7.3 PD in the sixth nerve palsy group (P = 0.003). In the sixth nerve palsy group, the improvement in primary gaze esotropia and abnormal head posture was more than the DRS group (Both P < 0.001).The average dose effect for SRT was 7.8 ± 2.2 PD in the DRS group and 19.2 ± 4.6 PD in the sixth nerve palsy group. Although objective intorsion was significantly induced after SRT, subjective torsion was not significant after surgery in both groups. SRT appears to be more effective in improving primary gaze deviation and head posture in sixth nerve palsy compared with DRS. Subjective torsional and vertical diplopia were rare in both groups.
Setareh Shomali - One of the best experts on this subject based on the ideXlab platform.
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Augmented superior rectus transposition procedure in Duane Retraction Syndrome compared with sixth nerve palsy
Graefe's Archive for Clinical and Experimental Ophthalmology, 2018Co-Authors: Mohammadreza Akbari, Setareh Shomali, Arash Mirmohammadsadeghi, Masoud Aghsaei FardAbstract:Purpose Superior rectus transposition (SRT) with medial rectus recession has been used for the treatment of sixth nerve palsy and esotropic Duane Retraction Syndrome (DRS). The purpose of this study was to compare the results of augmented SRT (with scleral fixation) without medial rectus recession in DRS and sixth nerve palsy. Methods Patients with unilateral esotropic DRS (DRS group) and sixth nerve palsy were included in this prospective, comparative study and underwent SRT. Preoperative forced duction testing was negative or slightly positive in both groups. Prospective measurements were compared between the two groups. Results There were 11 patients in the DRS group and 11 patients in the sixth nerve palsy group. The mean preoperative esotropia decreased from 20.9 ± 6.0 prism diopter (PD) at far to 13.2 ± 5.8 PD in the DRS group ( P = 0.003). The same measurement improved from 28.0 ± 8.5 PD to 8.4 ± 7.3 PD in the sixth nerve palsy group ( P = 0.003). In the sixth nerve palsy group, the improvement in primary gaze esotropia and abnormal head posture was more than the DRS group (Both P
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Augmented superior rectus transposition procedure in Duane Retraction Syndrome compared with sixth nerve palsy.
Graefes Archive for Clinical and Experimental Ophthalmology, 2018Co-Authors: Mohammadreza Akbari, Setareh Shomali, Arash Mirmohammadsadeghi, Masoud Aghsaei FardAbstract:Superior rectus transposition (SRT) with medial rectus recession has been used for the treatment of sixth nerve palsy and esotropic Duane Retraction Syndrome (DRS). The purpose of this study was to compare the results of augmented SRT (with scleral fixation) without medial rectus recession in DRS and sixth nerve palsy. Patients with unilateral esotropic DRS (DRS group) and sixth nerve palsy were included in this prospective, comparative study and underwent SRT. Preoperative forced duction testing was negative or slightly positive in both groups. Prospective measurements were compared between the two groups. There were 11 patients in the DRS group and 11 patients in the sixth nerve palsy group. The mean preoperative esotropia decreased from 20.9 ± 6.0 prism diopter (PD) at far to 13.2 ± 5.8 PD in the DRS group (P = 0.003). The same measurement improved from 28.0 ± 8.5 PD to 8.4 ± 7.3 PD in the sixth nerve palsy group (P = 0.003). In the sixth nerve palsy group, the improvement in primary gaze esotropia and abnormal head posture was more than the DRS group (Both P
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augmented superior rectus transposition procedure in Duane Retraction Syndrome compared with sixth nerve palsy
Graefes Archive for Clinical and Experimental Ophthalmology, 2018Co-Authors: Mohammadreza Akbari, Setareh Shomali, Arash Mirmohammadsadeghi, Masoud Aghsaei FardAbstract:Superior rectus transposition (SRT) with medial rectus recession has been used for the treatment of sixth nerve palsy and esotropic Duane Retraction Syndrome (DRS). The purpose of this study was to compare the results of augmented SRT (with scleral fixation) without medial rectus recession in DRS and sixth nerve palsy. Patients with unilateral esotropic DRS (DRS group) and sixth nerve palsy were included in this prospective, comparative study and underwent SRT. Preoperative forced duction testing was negative or slightly positive in both groups. Prospective measurements were compared between the two groups. There were 11 patients in the DRS group and 11 patients in the sixth nerve palsy group. The mean preoperative esotropia decreased from 20.9 ± 6.0 prism diopter (PD) at far to 13.2 ± 5.8 PD in the DRS group (P = 0.003). The same measurement improved from 28.0 ± 8.5 PD to 8.4 ± 7.3 PD in the sixth nerve palsy group (P = 0.003). In the sixth nerve palsy group, the improvement in primary gaze esotropia and abnormal head posture was more than the DRS group (Both P < 0.001).The average dose effect for SRT was 7.8 ± 2.2 PD in the DRS group and 19.2 ± 4.6 PD in the sixth nerve palsy group. Although objective intorsion was significantly induced after SRT, subjective torsion was not significant after surgery in both groups. SRT appears to be more effective in improving primary gaze deviation and head posture in sixth nerve palsy compared with DRS. Subjective torsional and vertical diplopia were rare in both groups.
