Purpose: To evaluate the surgical outcome of exotropic Duane syndrome and the factors that can influence the outcome.Methods: A retrospective study was performed on patients who had surgery for exotropic Duane syndrome with a minimum follow-up of 3 months. The ocular motility, the angles of deviation, the presence of abnormal head turn or overshoots, the surgical procedures performed, and their outcome were analyzed.Results: Sixty-seven patients were identified (mean age, 11.3 years). In unilateral cases with exotropia <25 PD (n = 28), ipsilateral lateral rectus (LR) recession was performed in all cases, and orthophoria was achieved in 25 patients (89.3%). In unilateral cases with angle ≥25 PD, ipsilateral LR recession was performed in 13 patients, bilateral symmetrical LR recession in eight patients, and unilateral LR recession and medial rectus (MR) resection in seven patients. Sequential contralateral LR recession for undercorrection was performed in seven patients. The success rate was highest in those who had unilateral LR recession and MR resection (66.7%). An increase in face turn occurred in 6 of 15 patients (40%) who had a simultaneous or sequential bilateral LR recession. In bilateral Duane syndrome, bilateral LR recession was performed in 10 patients, and was combined with ipsilateral MR resection in two patients with a success rate of 75%. Higher success rate was associated with young age at surgery (P = .03) and smaller angle of deviation (p = .04). The mean follow-up was 6.3 months.Conclusions: Surgical results in exotropic Duane syndrome are better in small angles of deviation and in younger age groups.

中文翻译：

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屈光性杜安综合征的手术结局。

目的：评价正性杜安综合征的手术效果及影响预后的因素。方法：回顾性研究正性杜安综合征患者的手术治疗，至少随访3个月。分析了眼部运动性，偏斜角度，是否出现异常的头转弯或过冲，手术步骤及其结果。结果：确定了67例患者（平均年龄11.3岁）。在单眼斜视力＜25 PD（n = 28）的单侧病例中，所有病例均进行同侧外侧直肌（LR）后退，25例（89.3％）实现了矫正。在PD≥25的单侧病例中，有13例患者进行了同侧LR后退，有8例患者进行了双侧对称性LR后退，以及单侧LR凹陷和内直肌（MR）切除7例。对7例患者进行了对侧LR对侧矫正不足的矫正。单侧LR衰退和MR切除的成功率最高（66.7％）。15例同时或继发性双侧LR衰退的患者中有6例（40％）发生了面部转向增加。在双侧Duane综合征中，有10例患者进行了双侧LR后退，并有2例患者与同侧MR切除相结合，成功率为75％。较高的成功率与手术时的年轻年龄（P = .03）和较小的偏角（p = .04）相关。平均随访时间为6.3个月。结论：散光性Duane综合征的手术结果在较小的偏斜角度和较年轻的年龄组中效果更好。