Journal article
Authors list: Graef, Michael; Hausmann, Anja; Lorenz, Birgit
Publication year: 2019
Pages: 2033-2041
Journal: Graefe's Archive for Clinical and Experimental Ophthalmology
Volume number: 257
Issue number: 9
ISSN: 0721-832X
eISSN: 1435-702X
DOI Link: https://doi.org/10.1007/s00417-019-04369-0
Publisher: Springer
Abstract:
Purpose To evaluate the effectiveness of a high-dose Anderson procedure (AP) to correct infantile nystagmus-related anomalous head turn (HT). Methods Twenty-nine consecutive orthotropes with infantile nystagmus with and without associated sensory defect received high-dose AP. HT was measured while the patient tried to read letters at best-corrected visual acuity (BCVA) level at 5 m and 0.3 m. BCVA, binocular vision (BV), and alignment (prism and cover test) were measured. High-dose AP with recessions of 9-16 mm was performed. All measures were taken before and 3-6 and >= 8 months post surgery. Success was defined by postoperative HT <= 10 degrees/HT <= 15 degrees. Results Medians and ranges (minimum-maximum) were:. Age at surgery was 7 years (4-44). HT at 5 m and HT at 0.3 m were 35 degrees (20-40) and 20 degrees (0-35), respectively. After 4 months (3-6), HT was 10 degrees (- 3-20) and 5 degrees (- 5-20); success rates were 74%/96% and 83%/96%. After 15 months (8-45), HT was 12 degrees (0-20) and 6 degrees (0-15); success rates were 46%/75% and 92%/100%; residual HT > 15 degrees occurred in 5/9 cases with recessions < 13 mm and 1/15 cases with recessions >= 13 mm. With recessions >= 13 mm, 60% (95% confidence intervals (C.I.), 33-83%) achieved HT <= 10 degrees and 93% (95% C.I. 66-99%) achieved HT <= 15 degrees. Overcorrection did not occur. Anomalous head posture components in vertical and frontal planes did not improve. Residual motility was 30 degrees (10-45). The mean BCVA improved by only 0.037 logMAR (p = 0.06). BV and ocular alignment were constant, except in 2 patients whose exophoria decompensated. Conclusions Kestenbaum surgery is a common procedure to correct infantile nystagmus-related HT. Anderson surgery is confined to bilateral yoke muscle recession; hence, less invasive but nevertheless comparably effective, high dosage is provided.
Citation Styles
Harvard Citation style: Graef, M., Hausmann, A. and Lorenz, B. (2019) High-dose Anderson operation for nystagmus-related anomalous head turn, Graefe's Archive for Clinical and Experimental Ophthalmology, 257(9), pp. 2033-2041. https://doi.org/10.1007/s00417-019-04369-0
APA Citation style: Graef, M., Hausmann, A., & Lorenz, B. (2019). High-dose Anderson operation for nystagmus-related anomalous head turn. Graefe's Archive for Clinical and Experimental Ophthalmology. 257(9), 2033-2041. https://doi.org/10.1007/s00417-019-04369-0
Keywords
Anderson; Anomalous head posture; CLINICAL-EVALUATION; INFANTILE NYSTAGMUS; Kestenbaum; KESTENBAUM PROCEDURE; Nystagmus surgery; POSTURE; SURGICAL-MANAGEMENT
