Aims To evaluate the outcomes following surgery on patients with bilateral Duane's Retraction Syndrome (DRS) associated with exotropia or exophoria.

Methods Eleven consecutive patients with exotropic DRS were identified in a 10-year period. The case notes were reviewed, and data was analysed to evaluate the results following surgery. The preoperative and postoperative outcomes were evaluated for the angle of deviation in primary position, abnormal head posture, stereovision for near-fixation and horizontal ocular ductions.

Results All patients had a significant improvement in their angle of deviation in primary position, and 82% had a residual angle within 10 prism dioptres of orthotropia/phoria (p<0.001). For those patients with abnormal head posture, 86% resolved or improved. The postoperative cumulative horizontal ocular ductions measured less in nine patients by an average of 1.5 units. Pre-existing near-stereovision improved in 83% of the patients by an average of 40″ arc.

Conclusions Surgery for bilateral exotropic DRS resulted in an improvement in the primary position angle and abnormal head posture. Patients demonstrated reduced cumulative horizontal ocular ductions restrictions and enhanced near-stereovision. This case series on exotropic bilateral DRS provides further evidence into successful postoperative surgical and functional outcomes.