RESUMEN
To report clinical features, types, and results of surgery for Duane's retraction syndrome [DRS]. This is an existing data study on the records of patients with DRS. The study was conducted on the hospital records of patients who were referred for DRS to a tertiacy eye center in Tehran, Iran during 8 years. The follow-up period after the surgery was at least 6 months. Data of 42 cases was studied. Mean age was 11.7 years [14 months to 25 years]. Twentyseven cases [64%] were female and 15 cases [36%] were male. The involved eye was left in 24 [57%], right in 13 [31%], and both eyes in 5 cases [12%]. Ocular alignment in primary position was esotropia in 20 [47.5%], exotropia in 14 [33.5%], and orthotropia in 8 cases [19%]. The most common type of DRS was type 1 [57%] followed by type 11 [31%] and type I11 [9%]. There was one case [3%] of synergistic divergence. Shooting phenomen was present in 17 [41%] patients. Ocular abnormalities were present in 16% and systemic abnormalities in 7%. Thirty-three cases [78.5%] underwent operation. Indications of surgery were ocular deviation [79%], abnormal head posture [51.5%], palpebral fissure changes and retraction [51.5%], and shooting [27%]. The operation was performed on one or two horizontal rectus muscles in 63% and on three or four muscles in 39%. Type of surgery was biomedial rectus recession and bilateral rectus recession in 63%, vertical muscles transposition in 27%, and splitting of the lateral rectus in 24%. In 61% of patients the affected eye improved with one operation. Abnormal head posture was improved in 76%. Cases with residual deviation, abnormal head posture, vertical deviation, or shooting phenomena were operated. DRS can be diagnosed clinically most of the times; signs and symptoms can be significantly improved with appropriately tailored operation on extraocular muscles