Comparison of Techniques for Correction of Chin-down Vertical Abnormal Head Position Associated with Infantile Nystagmus Syndrome
| Autor: | Yuxi Zheng, Derick G. Holt, David G. Morrison, James J. Law, Sean P. Donahue |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Chin genetic structures Adolescent Posture Visual Acuity Nystagmus Ophthalmologic Surgical Procedures 03 medical and health sciences 0302 clinical medicine Abnormal head medicine Humans Strabismus Child 030304 developmental biology Retrospective Studies 0303 health sciences Vision Binocular business.industry Infantile nystagmus syndrome Infant Retrospective cohort study musculoskeletal system medicine.disease eye diseases Surgery Ophthalmology medicine.anatomical_structure Oculomotor Muscles Child Preschool 030221 ophthalmology & optometry Female sense organs medicine.symptom business Esotropia Head Nystagmus Congenital Ophthalmologic Surgical Procedure Follow-Up Studies |
| Zdroj: | American journal of ophthalmology. 213 |
| ISSN: | 1879-1891 |
| Popis: | Purpose We evaluated the relative effectiveness of combined recession-resection of vertical rectus muscles versus superior rectus recession with inferior oblique weakening for patients who underwent surgical correction of chin-down abnormal head position (AHP) associated with infantile nystagmus syndrome (INS). Design Retrospective interventional case series. Methods This is a review of 22 patients who underwent surgical correction of chin-down vertical AHP associated with INS at an academic institution. The primary outcome was collapse of AHP. Unfavorable outcomes included repeat surgery and induced strabismus, in addition to failure of collapse of AHP. Results Twenty-two patients had chin-down AHP. Recession-resection (bilateral superior rectus recession 6-9 mm; bilateral inferior rectus resection 5-9 mm) was performed in 11 cases; weakening of both elevators (bilateral superior rectus recession 5-8 mm, bilateral inferior oblique recession or myectomy) occurred in 11 cases. Unfavorable outcome rates were 64% (7/11) compared with 18% (2/11), respectively (P = .03). Reoperation was performed for 6 of 22 patients. Five patients were from the recession-resection group, namely 3 for induced V-pattern esotropia, 1 for alternating esotropia, and 1 to correct recurrent AHP. The last of the 6 who required reoperation was in the elevator weakening group, and required correction of a recurrent AHP (P = .06). Conclusions While recession-resection of the vertical recti and weakening of both elevators each produce acceptable collapse of chin-down AHP, the former frequently induces a V-pattern esotropia requiring reoperation. |
| Databáze: | OpenAIRE |
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