Profound weakening of the lateral rectus muscle with attachment to lateral canthal tendon for treatment of exotropic Duane syndrome

An 8-year-old girl with exotropic Duane syndrome presented with upshoot, downshoot, and globe retraction in attempted adduction. To correct the alignment and treat the secondary aberrant movements, we weakened the lateral rectus muscle using a new surgical technique. In this approach, the lateral rectus muscle of the involved eye was disinserted and then attached to the lateral canthal tendon using nonabsorbable sutures. At the 3-week return visit, the patient was orthotropic in straight-ahead gaze with slightly improved adduction and negligible upshoot, downshoot, and globe retraction.