clinical features and results of surgery for duane’s retraction syndrome

purpose: to report clinical features, types, and results of surgery for duane’s retraction syndrome (drs). methods: this is an existing data study on the records of patients with drs. the study was conducted on the hospital records of patients who were referred for drs to a tertiacy eye center in tehran, iran during 8 years. the follow-up period after the surgery was at least 6 months. results: data of 42 cases was studied. mean age was 11.7 years (14 months to 25 years). twenty-seven cases (64%) were female and 15 cases (36%) were male. the involved eye was left in 24 (57%), right in 13 (31%), and both eyes in 5 cases (12%). ocular alignment in primary position was esotropia in 20 (47.5%), exotropia in 14 (33.5%), and orthotropia  in 8 cases (19%). the most common type of drs was type i (57%) followed by type ii (31%) and type iii (9%). there was one case (3%) of synergistic divergence. shooting phenomen was present in 17 (41%) patients. ocular abnormalities were present in 16% and systemic abnormalities in 7%. thirty-three cases (78.5%) underwent operation. indications of surgery were ocular deviation (79%), abnormal head posture (51.5%), palpebral fissure changes and retraction (51.5%), and shooting (27%). the operation was performed on one or two horizontal rectus muscles in 63% and on three or four muscles in 39%. type of surgery was bimedial rectus recession and bilateral rectus recession in 63%, vertical muscles transposition in 27%, and splitting of the lateral rectus in 24%. in 61% of patients the affected eye improved with one operation. abnormal head posture was improved in 76%. cases with residual deviation, abnormal head posture, vertical deviation, or shooting phenomena were re-operated. conclusion: drs can be diagnosed clinically most of the times; signs and symptoms can be significantly improved with appropriately tailored operation on extraocular muscles.