Surgical Approaches
In types A and B the most commonly adopted approach remains the recession of the medial recti of the affected eye, or of both eyes where the condition is bilateral. In type C, recession of the lateral recti is the method of choice.
The late Dr. Arthur Rosenbaum at UCLA championed the use of Vertical Rectus Transposition surgery. He reported significant increases in lateral eye movements in many cases. The VRT realigned muscles work with the good medial muscle to provide a "tripod" of musculature for the eye; the newly moved muscles provide torque and tension against the medial muscle, which is what allows for the central alignment. And, because they are "working" muscles, they also may allow for some range of lateral movement in their new positions. Morad et al. report the use of a similar approach in Duane's Type C.
Prominent down- or upshoots may be treated with a special form of muscle surgery, a "Y-splitting" procedure, often combined with a recession.
Read more about this topic: Duane Syndrome
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