Modified Y splitting procedure for the treatment of Duane Retraction Syndrome
Ayse Gul Altintas1, Hasan Basri Arifoglu2, Sukru Gultekin Koklu11Ulucanlar Eye Research And Education Hospital, Ankara2Kayseri Research And Education Hospital, Ophthalmology Department, Kayseri
Purpose: Outcomes of modified lateral rectus Y splitting combined either unilateral or bilateral horizontal rectus recession in Duane Retraction Syndrome with significant up-shoot or down-shoot.
Methods: A total of 12 patients including 10 patients had Type I, 2 had Type III DRS underwent modified Y splitting surgery. Amount of additional recessions varied with the degree of preoperative deviation by intra-operative adjustable suture technique. Preoperatively 3 patients had ET, 6 had XT, and 3 patients had orthotropia. The mean preoperative deviation in cases with ET was 19.3 Prism Diopter (PD) (range 18-20 PD) and it was 19.2 PD (range 16-20 PD) in XT.
Results: Postoperatively all patient had significant correction in horizontal deviation and aligned within 4 prism diopter (PD) of orthotropia. No one had abnormal head posture (AHP). Co-contraction and globe retraction were markedly relieved and abnormal ocular vertical movement disappeared or significantly reduced in all cases. No one had recurrent of ocular motility disorders in average 26 months (13 months to 66 months) follow up period.
Methods: A total of 12 patients underwent modified Y splitting surgery. Amount of additional recessions varied with the degree of preoperative deviation by intra-operative adjustable suture technique. A cure was defined by elimination of the excursion of the adducted eye in elevation and depression; diminish globe retraction and correct horizontal deviation.
Results: Postoperatively all patient aligned within 4 prism diopter (PD) of orthotropia, had no abnormal head position. Co-contraction and globe retraction were markedly relieved and abnormal ocular vertical movement disappeared or significantly reduced in all cases. No one had recurrent of ocular motility disorders in average 26 months (13 months to 66 months) follow up period.
Conclusion: Modified Y splitting surgery, combined with co-contracting horizontal muscle recession technique seems to be safe and effective treatment in DRS.
Duane retraksiyon sendromu tedavisinde modifiye Y splitting uygulaması
Ayse Gul Altintas1, Hasan Basri Arifoglu2, Sukru Gultekin Koklu11Ulucanlar Göz Eğitim Ve Araştırma Hastanesi, Ankara2Kayseri Eğitim Ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, Kayseri
Amaç: Belirgin aşağı vuruş veya yukarı vuruş ile birliktelik gösteren Duane Retaraksiyon Sendromlu (DRS) gözlerde tek taraflı veya iki taraflı rektus geriletmesi ile kombine modifiye dış rektus Y splitting sonuçlarının bildirilmesi
Gereç ve Yöntem: Modifiye Y splitting geçirmiş, 10’u Tip I ve 2’si Tip 3 olmak üzere on iki hasta çalışmaya dahil edildi. Ayarlanabilir intraoperatif sütür tekniği kullanılarak preoperatif kayma derecesine bağlı olarak geriletme miktarı belirlendi. Preoperatif (Preop) dönemde 3 hastada Ezodeviasyon (ET), 6 hastada ekzodeviasyon (XT) varken 3 hasta ortotropikti. Ortalama preop kayma ET’li olgularda 19.3 (min 18-max 20) Prizm Dioptri (PD), XT grubunda 19.2 (min 16- max 20) PD idi.
Bulgular: Ameliyat sonrasında tüm hastalarda horizontal kaymada belirgin düzelme olup ortoforik veya 4 PD altında kayma gözlemlendi, preop olan anormal baş pozisyonu hiçbirinde izlenmedi. Olgularda ko-kontraksiyon ve glob retraksiyonu izlenmedi. Anormal vertikal göz hareketleri tamamen kayboldu veya çok belirgin olarak azaldı. Hiçbir hastada ortalama 26 haftalık takip zamanında (13 ile 66 ay arası) rekürren göz hareket bozukluğu izlenmedi.
Sonuç: Ko-kontrakte horizontal kas geriletmesi ile birlikte uygulanan modifiye Y splitting cerrahisi DRS de güvenilir ve etkili bir tedavi yöntemi olarak görülmektedir.
Corresponding Author: Hasan Basri Arifoglu, Türkiye
| TOOLS |
 Print Download citation RIS EndNote BibTex Medlars Procite Reference Manager Share with email Share Send email to author
Similar articles Google Scholar |