Vertical Rectus Muscle Transposition for Correcting Abduction Deficiency in Duane's Syndrome Type 1 and Sixth Nerve Palsy

Purpose: To report the clinical outcome and complications of the Scott Foster procedure for treating abduction deficiency in patients with Duane's syndrome type 1 and sixth nerve palsy. Methods: A retrospective, interventional case series included 62 consecutive patients (62 eyes: 38 eyes with Duane's syndrome and 24 eyes with sixth nerve palsy) who underwent the Scott Foster procedure for treatment of abduction deficiency. The main outcome measures were deviation, face turn, and abduction deficiency. Results: In patients with sixth nerve palsy, mean distance deviation improved from 44.7 ± 7.2 prism diopters (PD) before surgery to 12.5 ± 4.0 PD after surgery ( P < .05), and in patients with Duane's syndrome type 1, mean distance deviation improved from 31.5 ± 4.3 PD preoperatively to 9.2 ± 3.1 PD. Mean near deviation improved from 27.1 ± 4.5 PD to 6.2 ± 2.5 PD in patients with Duane's syndrome and from 40.3 ± 6.2 PD to 13.7 ± 3.4 PD in patients with sixth nerve palsy. Mean abduction deficiency improved from −4 to −2 ( P < .05) in both groups. Face turn improved significantly after surgery. No patient had an overcorrection. No recurrence was detected. Conclusion: The Scott Foster procedure is effective for improving deviation, abduction deficiency, and face turn in patients with Duane's syndrome type 1 and especially in those with sixth nerve palsy. [J Pediatr Ophthalmol Strabismus 2010;47:96–100.]