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Successful outcome in synergistic divergence after unilateral lateral rectus recession and medial rectus resection. | LitMetric

Successful outcome in synergistic divergence after unilateral lateral rectus recession and medial rectus resection.

J AAPOS

Department of Ophthalmology, Brown University Warren Alpert Medical School and Rhode Island Hospital (RIH), Providence, Rhode Island; Pediatric Ophthalmology and Strabismus Associates, Providence, Rhode Island.

Published: December 2024

AI Article Synopsis

  • Synergistic divergence, or type IV Duane syndrome, is a congenital disorder marked by unusual eye muscle control leading to both eyes moving outward when trying to look to one side.
  • A case study of a 23-year-old man highlighted his strabismus surgery to address a significant right exotropia and a left head turn developed for better vision since childhood.
  • The surgery involved a combination of a 14 mm recession of the right lateral rectus and a 10 mm resection of the right medial rectus, suggesting this approach as an effective treatment for the condition.

Article Abstract

Synergistic divergence, sometimes identified as type IV Duane syndrome, belongs to a group of congenital disorders characterized by aberrant extraocular muscle innervation. In synergistic divergence, there is paradoxical abduction of both eyes on attempted gaze to one side. There is no consensus on surgical management of this rare disorder. We present the case of a 23-year-old man who underwent strabismus surgery for a large right exotropia and compensatory left head turn, which he had adopted to maintain single binocular vision from at least 4 months of age, when he first presented with strabismus. The left head turn was corrected with a 14 mm right lateral rectus recession and a 10 mm right medial rectus resection. Although surgical correction by means of lateral rectus periosteal fixation or extirpation has been reported previously, this case supports large recession and resection as an alternative for surgical treatment of synergistic divergence.

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Source
http://dx.doi.org/10.1016/j.jaapos.2024.104092DOI Listing

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