Zandi Alireza, Amirkhani Arman, Pourazizi Mohsen
Department of Ophthalmology, Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2020 May 22;25:54. doi: 10.4103/jrms.JRMS_836_19. eCollection 2020.
Duane's retraction syndrome is a congenital eye movement anomaly with narrowing of the palpebral fissure and globe retraction on attempted adduction. There are several surgical approaches to treat the narrowing of the palpebral fissure. The purpose of the present study was to evaluate the efficacy of unilateral medial rectus recession (MRR) muscle combined lateral rectus (LR) muscle marginal myotomy (MM) with unilateral MRR alone in the management of narrowing of the palpebral fissure of patients with Type 1 Duane's retraction syndrome (DRS).
Twenty-eight patients with unilateral DRS Type 1 were randomly divided into two groups (14 eyes of 14 patients in each group). Age ≥5 years with DRS Type 1 with <20 prism diopters in primary position who were candidates for surgery were consecutively enrolled in this randomized controlled trial. Patients were divided into treatment groups to receive unilateral MR recession with simultaneous MM group or with unilateral MR recession alone. The amount of deviation in primary position, abnormal head position, palpebral fissure width (PFW), and up/down shoot was evaluated before and 3 months after the surgery. This study was registered at the Iranian Registry of Clinical Trials under the registration code IRCT20131229015975N3.
PFW increased within MRR/MM group at the end of the study (8.86 ± 1.51) compared with the baseline (7.79 ± 1.48) ( < 0.001). In contrast, in the MRR/MM group, PFW did not increase statistically significantly within the MRR group at the end of the study (8.14 ± 1.35) compared with the baseline (8.07 ± 1.38) ( = 0.67). Mean ± standard deviation of PFW (mm) in MRR/MM group after surgery (8.86 ± 1.51) was statistically significantly higher than that in the MRR group (8.14 ± 1.35), ( = 0.002).
The results of our study demonstrate PFW significantly increased after unilateral MRR muscle combined LR muscle MM.
杜安眼球后退综合征是一种先天性眼球运动异常，表现为试图内收时睑裂变窄和眼球后退。有多种手术方法可治疗睑裂狭窄。本研究的目的是评估单侧内直肌后退术（MRR）联合外直肌（LR）边缘肌切开术（MM）与单纯单侧MRR治疗1型杜安眼球后退综合征（DRS）患者睑裂狭窄的疗效。
28例单侧1型DRS患者被随机分为两组（每组14例患者的14只眼）。年龄≥5岁、1型DRS、原在位斜视度<20棱镜度且适合手术的患者连续纳入本随机对照试验。患者分为治疗组，分别接受单侧MR后退联合MM组或单纯单侧MR后退组。在手术前和手术后3个月评估原在位的斜视度、异常头位、睑裂宽度（PFW）和上下冲动。本研究在伊朗临床试验注册中心注册，注册号为IRCT20131229015975N3。
研究结束时，MRR/MM组的PFW较基线（7.79±1.48）增加（8.86±1.51）（<0.001）。相比之下，在MRR/MM组中，研究结束时MRR组的PFW与基线（8.07±1.38）相比无统计学显著增加（8.14±1.35）（=0.67）。MRR/MM组术后PFW（mm）的平均值±标准差（8.86±1.51）显著高于MRR组（8.14±1.35），（=0.002）。
我们的研究结果表明，单侧MRR联合LR肌MM术后PFW显著增加。
