gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Surgical options in Duane's retraction syndrome

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  • corresponding author J. Fricke - Zentrum für Augenheilkunde der Universität zu Köln, Abteilung Schielbehandlung und Neuroophthalmologie
  • A. Neugebauer - Zentrum für Augenheilkunde der Universität zu Köln, Abteilung Schielbehandlung und Neuroophthalmologie
  • W. Rüßmann - Zentrum für Augenheilkunde der Universität zu Köln, Abteilung Schielbehandlung und Neuroophthalmologie

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogFR.10.10

The electronic version of this article is the complete one and can be found online at:

Published: September 22, 2004

© 2004 Fricke et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




Most cases of connatal ocular misinnervation are caused by Duane´s retraction syndrome. Hypo- or aplasia of the sixth nerve combined of miswiring of third nerve fibers to lateral rectus cause clinically typical images with limitation of horizontal eye movements globe retraction and narrowing of the palpebral fissure. A causative therapy does not exist. Eye muscle surgery is indicated in cases with manifest strabismus in primary position and an annoying compensatory head posture to maintain binocular singel vision. Different surgical approaches to different types of Duane's retraction syndrome are described in the literature: Recession of one horizontal rectus muscle, recession - maybe asymmetric - of two antagonistic horizontal recti in cases of severe retraction, combined surgery with recessing and resecting procedures, transposition of vertical muscles and surgery on the fellow eye have been described.


We retrospectively analyzed the pre- and postoperative findings of all patients who underwent surgery in our clinic because of Duane's retraction syndrome during the years 1999-2004. Type of retraction syndrome, angle reduction in primary position and reduction of head posture were evaluated in regard to the surgical procedure chosen.


42 patients aged between 2 and 68 years had received surgery. In 27 cases by a single recession of the medial rectus (15 and 3 revisions) or lateral rectus (7 and 2 revisions) the surgical aim was attained. In 9 cases combined surgery with additional tuck of the lateral rectus (6 and 2 revisions) or the medial rectus (1) was performed. In 4 cases solely the lateral rectus (2) was tightened by a tuck or the medial rectus (2 revisions) was advanced. In 2 cases an asymmetrical recession of both horizontal recti was chosen. We discuss the effect of the different procedures on the squint angle an the head posture.


Depending on the type of retraction syndrome, angle in primary position, head posture and globe retraction different surgical options exist to aim at rehabilitation of the patient with Duane´s retraction syndrome.