Nishida’s procedure combined with medial rectus recession for large-angle esotropia in Duane syndrome

Background Two patients presented large-angle esotropia due to unilatelal Duane syndrome type I. Cases We report the course of a simple muscle transposition procedure (the Nishida procedure) with medial rectus muscle recession for large-angle esotropia in two cases of unilateral Duane syndrome type I. Observations Case 1: A 5-year-old boy had Duane syndrome type I OS. He had esotropia of 40 prism diopters, and the left eye could not abduct to the midline. Postoperatively, his esotropia decreased to 6 prism diopters and the abduction improved to 45°. Case 2: A 5-year-old girl had Duane syndrome type I OS with a marked facial turn. She had esotropia of 40 prism diopters in primary position, and the left eye could not abduct to midline. Postoperatively, the facial turn resolved, the esotropia decreased to 8 prism diopters, and the abduction improved to 30°. Conclusion This procedure improves large-angle esotropia and abduction deficits in unilateral Duane syndrome type I.