J Korean Ophthalmol Soc > Volume 60(6); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(6):569-574.
DOI: https://doi.org/10.3341/jkos.2019.60.6.569    Published online June 15, 2019.
Modified Anderson Procedure in Infantile Nystagmus with Face Turn within 30 Degrees.
Sang Cheol Yang, Hyeshin Jeon, Hee Young Choi
1Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea. hychoi@pusan.ac.kr
2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
30° 이내의 얼굴돌림을 보인 영아눈떨림환자에서 Modified Anderson 술식
양상철1·전혜신1,2·최희영1,2
부산대학교 의과대학 안과학교실1, 부산대학교병원 의생명연구원2
Correspondence:  Hee Young Choi,
Email: hychoi@pusan.ac.kr
Received: 10 January 2019   • Revised: 16 February 2019   • Accepted: 17 May 2019
Abstract
PURPOSE
To evaluate the efficacy of modified Anderson procedure in infantile nystagmus with face turn less than 30 degrees. METHODS: This study was a retrospective review of the medical records of 13 consecutive patients who underwent a modified Anderson procedure for abnormal head position in infantile nystagmus at Pusan National University hospital from February 2002 to March 2017. We compared best-corrected visual acuity (logarithm of minimal angle of resolution, logMAR), refraction, degree of face turn, ocular motility, and angle of deviation preoperatively and at 1 week postoperatively, 6 months postoperatively, and the final visit. Recession of the yoke rectus muscles responsible for the slow phase of nystagmus was performed, depending on the direction of face turn; the medial rectus muscle of the eye to which the head was turned was recessed 10 mm, whereas the lateral rectus muscle of the contralateral eye was recessed 12 mm. RESULTS: The mean age of the patients was 8.9 (2–25) years, and the mean follow-up period after surgery was 51.3 (6–183) months. Twelve patients (92.3%) had no residual head posture or <10° at 6 months postoperatively, and three patients (23.1%) achieved this outcome with an additional operation. The mean degrees of face turn were 22.30° before surgery and 3.85° post-operatively (p = 0.001). Best-corrected visual acuity (logMAR) was 0.41 in the better eye and 0.50 in the worse eye before surgery; this improved to 0.34 and 0.45 at 6 months postoperatively (p = 0.068 and p = 0.228, respectively). Despite the large recessions involved, only one patient showed mild limitation of abduction after surgery. CONCLUSIONS: The modified Anderson procedure may be effective for correcting abnormal head position in infantile nystagmus with face turn less than 30 degrees; patients were not overcorrected.
Key Words: Abnormal head position;Modified Anderson procedure;Nystagmus
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