Evaluation of the Role of Displacement Surgery in the Management of Congenital Nystagmus
Keywords:
Nystagmus, Abnormal head posture, Tenotomy, Immobilization surgery, Displacement surgeryAbstract
Introduction: The aim of this study was to assess the effectiveness of displacement surgery in damping of ocular oscillation and management of compensatory head posture in patients of congenital nystagmus.
Methods: This study was carried out in 2014. The participants were 50 patients with congenital nystagmus that dampens in a certain direction of gaze with or without abnormal head posture and with or without strabismus. Patients underwent the augmented modified Kestenbaum (augmented parks) procedure. Data were analyzed by SPSS version 15, using Chi-square text, exact test, and Mann Whitney U test.
Results: In this study, 12 patients (80%) were noticed clinically to have damping of nystagmus while 3 patients (20%) had no damping of nystagmus. Twelve patients (80.0%) had no post-operative abnormal head position, while 3 patients (20.0%) had residual abnormal head position. There was a statistically significant difference between the pre-operative BCVA in primary position and post-operative BCVA in primary position (p = 0.001 for both right and left eyes).
Conclusion: The displacement surgeries (e.g. Kestenbaum procedure) for the treatment of patients with congenital nystagmus is an effective procedure for correction of abnormal head posture, improving the visual acuity in the primary position and damping of nystagmus in patients with congenital nystagmus who have null points away from the primary position.
References
Cesarelli M, Bifulco P, Loffredo L, Bracale M. Relationship between visual acuity and eye position
variability during foveations in congenital nystagmus. Doc Ophthalmol. 2000; 101(1): 59-72. doi:
1023/A:1002702609387, PMID: 11128969.
Dell'Osso LF, Hertle RW, Daroff RB. Sensory and motor nystagmus erroneous and misleading terminology
based on misinterpretation of David Cogan’s observation. Arch Ophthalmol. 2007; 125(11): 1559-61,
doi: 10.1001/archopht.125.11.1559, PMID: 17998518.
Spielmann A. Congenital nystagmus: clinical types and their surgical treatment. Ophthalmologica
(Basel).2001; 182: 65-72. doi: 10.1159/000309093.
Graf M, Droutsas K, Kaufmann H. Surgery for nystagmus related head turn: Kestenbaum procedure and
artificial divergence. Graefes Arch Clin Exp Ophthalmol. 2001; 239(5): 334-41. PMID: 11482336.
Weil A. Dealing with dancing eyes. Optom Vis Sci. 2013; 69: 447-50.
Bagheri A, Aletaha M, Abrishami M. Kestanbaum procedure for nystagmus related abnormal head
position. Graefes Arch Clin Exp Ophthalmol. 2009; 247(10): 1395-400. doi: 10.1007/s00417-009-1083-9.
Kumar A, Shetty S, Vijayalakshmi P, Hertle RW. Improvement in visual acuity following surgery for
correction of head posture in infantile nystagmus syndrome. J Pediatr Ophthalmol Strabismus. 2011; 48(6):
-6. doi: 10.3928/01913913-20110118-02.
Taylor JN, Jesse K. Surgical management of congenital nystagmus. Aust NZ J Ophthalmol. 1987; 15: 25- 34. doi: 10.1111/j.1442-9071.1987.tb01779.x, PMID: 3593562.
Lee IS, Lee JB, Kim HS, Lew H, Han SH. Modified Kestenbaum surgery for correction of abnormal head
posture in infantile nystagmus: outcome in 63 patients with graded augmentaton. Binocul Vis Strabismus
Q. 2000; 15(1): 53-8, PMID: 10767683
Chang YH, Chang JH, Han SH, Lee JB. Outcome study of two standard and graduated augmented
modified Kestenbaum surgery protocols for abnormal head postures in infantile nystagmus. Binocul Vis
Strabismus Q. 2007; 22: 235-41. PMID: 18163900.
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