Duane's retraction syndrome is a deficiency in abduction and a defect in abduction movements, with retraction and narrowing of the palpebral fissure of the affected eye. In addition, there are often an upshoot or downshoot of the affected eye on attempted abduction, widening of the palpebral fissure with abduction and mild to marked defect in convergence. But, the clinical picture in Duane's retraction syndrome is extremely variable. Two cases of Duane's retraction syndrome are presented, each of them is Duane's type I and type III, which are affected on left eye. The literatures relating to this syndrome are briefly reviewed.
Duane Retraction Syndrome*

The upshoot and downshoot in Duane's retraction syndrome is believed to be related to a leash effect from the lateral rectus muscle. When the eye is rotated into the adducted position, the lateral rectus muscle slips over the globe, producing the up-and downshoot on adduction. The splitting of the ends of the lateral rectus into a Y configuration prevents the rotation of the globe up or down by stabilizing the muscle's position on the eye. Three patients with Duane's retraction syndrome demonstrated abnormal vertical movement on adduction and underwent a Y-splitting on the lateral rectus. In all patients, marked decrease in the up-and downshoot in noted after surgery.
Duane Retraction Syndrome* ; Humans

The retraction syndrome in its classic form is characterized that severe limitation of abduction, slightly limitation of adduction, globe retraction and narrowing of the palpebral fissure on adduction, frequently associated elevation or depression in adduction, and convergency insufficiency. While many authors reported this type, there were few reports about inverse Duane's retraction syndrome, as exotropia in primary position, severe limitation of adduction. globe retraction and narrowing palpebral fissure on abduction. So the authors present a case of inversed Duane's retraction syndrome.
Depression ; Duane Retraction Syndrome* ; Exotropia

No abstract available.
Duane Retraction Syndrome* ; Facial Paralysis ; Mobius Syndrome*

The upshoot or downshoot that occurs when an eye is adducted in Duane's retraction syndrome is believed to be related to a taut lateral rectus muscle. When an eye is adducted, the lateral rectus muscle is slipped over the globe, producing this abnormal eye movement. Seven patients with Duane's retraction syndrome demonstrated this findings and underwent an Y-splitting operation on the lateral rectus muscle. Y-splitting and recession of the lateral rectus muscle is safe and simple procedure. All 7 patients demonstrated markedly decrease in the upshoot or downshoot after surgery.
Duane Retraction Syndrome ; Eye Movements ; Humans

PURPOSE: To present the results of patients undergoing surgical treatment and determine clinical guidelines for the face turn, and up and down shoot in Duane retraction syndrome (DRS). METHODS: Thirty-four patients with DRS were treated with single horizontal rectus muscle recession, lateral rectus (LR) recession with Y-splitting, or LR recession with Y-splitting combined with medial rectus (MR) recession. The different treatment approaches were based on the angle of deviation in the primary position, versions, and ductions. In all patients, ocular alignment, face turn and up and down shoot were assessed preoperatively and postoperatively. RESULTS: The average standard deviation reduced from 18.5 +/- 6.5 prism diopters (PD) to 4.6 +/- 5.8 PD in horizontal rectus muscle recession and 14.4 +/- 5.5 PD to 1.6 +/- 2.8 PD in LR recession with Y-splitting. LR recession with Y-splitting combined with MR recession was effective in reducing globe retraction. Postoperative 4-mm LR recession with Y-splitting did not change ocular alignment; 7-mm LR recession with Y-splitting showed an average correction of 12.8 PD. Postoperatively, all patients presented a reduction in face turn; however, there was no statistically significant difference between the 2 procedures (Mann-Whitney U test, p = 0.620). CONCLUSIONS: Decisions regarding surgical approaches in DRS should be based on the amount of deviation in primary eye position, the expression of up and down shoot, and the degree of face turn. Surgeons planning Y-splitting of LR with MR recession must consider modifying the MR recession amount due to the smaller LR recession effect of Y-splitting compared with conventional LR recession.
Duane Retraction Syndrome ; Eye ; Humans ; Muscles

The authors reviewed medical records of 25 patients undergoing treatment for Duanes retraction syndrome. The patients were treated with appropriate horizontal muscle recession with or without posterior fixation suture, transposition procedures, and lateral rectus Y split and recession in order to relieve face turn, significant tropia in primary position, and upshoot or downshoot. The deviation in primary position was reduced by an average or 20.5 prism diopters; 19.5 prism diopters in horizontal muscle recession with or without posterior fixation suture, and 17.4 prism diopters in lateral rectus Y split and recession. The face turn was eliminated in 84%, while 100% in horizontal muscle recession with posterior fixation suture. The upshoot or downshoot was essentially corrected by lateral rectus Y split and recession(100%). Motility of the eye was not increased following each surgical procedures. According to the results, we could obtain appropriate deviation in primary position with each surgery postoperatively. Horizontal muscle recession with posterior fixation suture was effective in eliminating the face turn. Lateral rectus muscle Y-split and recession effectively corrected upshoot and downshoots.
Duane Retraction Syndrome* ; Humans ; Medical Records ; Sutures

Inverse Duane's retraction syndrome is very uncommon. Congenital cases are even more unusual. A 6-year-old girl with convergent squint along with severe restriction on abduction is described. On attempted abduction, a narrowing of the palpebral fissure, upshoot and retraction of the eyeball were observed. Brain and orbit MRI demonstrated no intracranial or intraorbital mass, fracture, or entrapment of the medial rectus. Forced duction test was strongly positive. The primary lesion was found to be a tight medial rectus with shortening and soft tissue contracture. Surgical tenotomy of the medial rectus led to successful postoperative motility, but some limitation at full adduction and abduction persisted. This is a case reported with congenital medial rectus shortening, suggesting that this condition may be one of the etiologies of the rare inverse Duane's retraction syndrome.
Case Report ; Child ; Contracture/physiopathology ; Contracture/etiology ; Duane Retraction Syndrome/surgery ; Duane Retraction Syndrome/physiopathology ; Duane Retraction Syndrome/congenital* ; Duane Retraction Syndrome/complications ; Eye Movements ; Female ; Human ; Oculomotor Muscles/surgery ; Oculomotor Muscles/physiopathology

The recurrent pterygium can be caused by repeating excisions for simple pterygium. The severe conjunctival cicatrization on the area of the medial rectus muscle limits abduction and results in diplopia and it is one of the causes of acquired retraction syndrome. We experienced two patients who have marked abducticn limitation and diplopia in all directions of gaze by recurrent pterygium. In order to eliminate these troblesome symptoms and signs with only one surgery, we performed conjunctival autograft transplantation in one patient and on the other patient with bilateral recurrent pterygium, the procedure was performed with resection of the lateral rectus using adjustable suture at one time. The limitation of ocular movement and diplopia were completely gone postoperatively.
Autografts ; Cicatrix ; Diplopia ; Duane Retraction Syndrome ; Esotropia* ; Humans ; Pterygium* ; Sutures

The most common type of ocular miswiring is Marcus Gunn jaw winking phenomenon and Duane's retraction syndrome and the next most common is pseudo inferior oblique overaction. The association of Marcus Gunn jaw winking and pseudo inferior oblique overaction has not been previously reported. The authors describe a 21-year-old woman with both Marcus Gunn jaw winking phenomenon and pseudo inferior oblique overaction. This coexistence in the present case may provide some support to the existing concept that both phenomena are caused by an ocular aberrant innervation. This unusual combination suggests that multiple aberrant innervation patterns can occur in the same patient. The occurrence of ocular miswiring is more common than is indicated by the few reports in the literature.
Blinking* ; Duane Retraction Syndrome ; Female ; Humans ; Jaw* ; Young Adult