Isolated Y splitting and recession of the lateral rectus muscle in patients with exo-Duane syndrome.

摘要

We read with great interest the article published by Velez et al. on the role of Y splitting and simultaneous recession of the lateral rectus as a successful treatment modality for exotropic Duane retraction syndrome (DRS) (Velez et al., 2012). The authors have shown that head posture, ocular deviation, and associated signs of DRS can be effectively corrected by tackling the lateral rectus only. Table 2 shows that 3 out of 10 cases required additional surgery. The amount of recession done varied from 7 to 17 mm. It would be interesting to know how the amount of muscle to be recessed was calculated. Rao et al. have stated that it is the primary position deviation that matters when deciding upon surgical intervention in DRS (Rao et al., 2003). The variation in the amount of lateral rectus recession performed by Velez et al. in different patients with the same amount of primary position deviation leaves the reader with a lot to interpret. As shown in Table 2, 60% of patients still had a residual exotropia ranging from 6 prism diopters (PD) to 14 PD after surgery.