Surgical treatment for correcting abnormal mixed head position in nystagmus with a predominant head turn / 眼科

ABSTRACT

Objective To evaluate the surgical effect for congenital nystagmus (CN) with an abnormal head position in all three axes of a predominant head turn. Design Retrospective case series. Participants 11 patients with horizontal nystagmus and abnormal head position treated in Xingtai Eye Hospital during 2003-2008. All had an abnormal head position in all three axes with a predomi-nant head turn. Methods Recession of the yoke muscles responsible for the slow phase of nystagmus (one medial rectus of 6mm, and one lateral rectus 8 mm), and simultaneously resection of the yoke muscles responsible for the fast phase of nystagmus (the other lateral rectus 9 mm, and medial rectus 7 mm) were performed. The follow-up was from 6 to 20 months. Main Outcome Measures The visual acuity of both eyes in primary position, the degree of head turn, chin elevation or depression, head tilt. Results At the last follow-up, the all 11 patients undergoing the operation for CN gained two or more lines of Snellen acuity with both eyes in primary position for be-ing corrected best. The postoperative mixed head position of 9 cases got disappear or ≤ 10°. Of 1 case developed overcorrection of the head turn. 1 case has the head turn of ≤15°, and 1 case remained the head turn of 25°. Conclusion Recessions and resections of the horizontal yoke rectus muscles in nystagmus with blockage position, when the head turn predominates over the vertical and torsional components, are effective in diminishing the abnormal head position on all three axes, and improve the visual acuity with both eyes in primary position. (Ophthalmol CHN, 2009, 18 275-278)