Vertical muscle transposition augmented with lateral fixation (Foster) suture for Duane syndrome and sixth nerve palsy.

Abstract

PURPOSE:

To report the postoperative results of full-tendon vertical rectus transposition (VRT) augmented with lateral fixation suture for the treatment of type 1 Duane syndrome and sixth nerve palsy and to determine whether there was a decrease in the effect of the Foster suture over time.

METHODS:

This retrospective, consecutive case series included patients who underwent a full-tendon VRT transposition with lateral fixation for type 1 Duane syndrome or sixth nerve palsy. The primary outcome measures included deviation, abnormal head posture(AHP), abduction deficiency, and postoperative binocular single visual field (BSVF).

RESULTS:

Eighty-seven patients (87 eyes: 40 eyes with Duane syndrome and 47 eyes with sixth nerve palsy) were included in this study. In Duane syndrome patients, the deviation was reduced by a mean of 95%, the AHP was eliminated in 86% of patients, the abduction was improved by 42%, and a useful BSVF of ≈ 67% of normal was achieved at 1 year post operation. In sixth nerve palsy patients, the deviation was reduced by 99%, the abduction was improved by 59%, and a useful BSVF of ≈ 71% of normal was achieved at 1 year post operation. In both groups, the improvements in deviation angle and abduction were stable postoperatively. Sixteen patients needed reoperation for undercorrection.

CONCLUSION:

VRT surgery with posterior fixation is an effective treatment method for complete sixth nerve palsy and Duane syndrome with esotropia, AHP, and abduction deficiency. The procedure carries a small risk of reoperation for undercorrection. The effect of the Foster suture did not decline over time.

• Authors: S Akar, B Gokyigit, G Pekel, A Demircan, A Demirok
• Journal: Eye (London, England) (Eye (Lond)) Vol. 27 Issue 10 Pg. 1188-95 (Oct 2013) ISSN: 1476-5454 [Electronic] England
• PMID: 23907625 (Publication Type: Journal Article)

Topics

• Abducens Nerve Diseases (surgery)
• Adolescent
• Adult
• Aged
• Child
• Child, Preschool
• Duane Retraction Syndrome (surgery)
• Esotropia (surgery)
• Female
• Humans
• Male
• Middle Aged
• Oculomotor Muscles (surgery)
• Ophthalmologic Surgical Procedures
• Retrospective Studies
• Suture Techniques
• Tendon Transfer (methods)
• Young Adult