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Year : 2022  |  Volume : 2  |  Issue : 4  |  Page : 948-951

Superior rectus recession combined with lateral rectus recession and Y-split surgery for exotropia with large comitant innervational hypertropia in a case of type III Duane retraction syndrome

1 Department of Pediatric Ophthalmology, Strabismus and Neuroophthalmology, MS Ophthalmology, Dr. Om Parkash Eye Institute, Amritsar, Punjab, India
2 Department of Pediataric Ophthalmology, Strabismus Abd Neuro-Ophthalmology, MS Ophthalmology DNBE, Dr. Shroff's Charity Eye Hospital, Daryaganj, Delhi, India

Correspondence Address:
Dr. Suma Ganesh
Dr Shroff Charity Eye Hospital, 5027, Kedar Nath Road, Daryaganj, New Delhi - 110 002
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_421_22

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The aim of this study is to report a case of hypertropia with severe globe retraction and innervational upshoot present in type III Duane retraction syndrome (DRS) and its management. We report a case of a 24-year-old male with type III DRS with large hypertropia and exotropia, 90° upshoot (grade 4) on attempted adduction, globe retraction on adduction and depression and significant face turn. MRI brain and orbit revealed absence of right abducens nerve with relative low position of horizontal rectus muscles, representing the bridle effect, with normal inferior rectus and superior rectus. The case was managed by performing right eye lateral rectus recession with Y-split for the severe upshoot and superior rectus recession for the hypertropia. Recession of the superior rectus muscle along with lateral rectus recession with Y-split is a safe and effective treatment of type III DRS cases with hypertropia and exotropia.

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