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High-dose Anderson operation for nystagmus-related anomalous head turn

Graefe's Archive for Clinical and Experimental Ophthalmology Aug 24, 2019

Gräf M, et al. - Researchers evaluated a high-dose Anderson procedure (AP) for efficacy in correcting infantile nystagmus–related anomalous head turn (HT). In this study, high-dose AP was received by 29 consecutive orthotropes with infantile nystagmus with and without associated sensory defect. They measured HT while the patient attempted to read letters at best-corrected visual acuity (BCVA) level at 5 m and 0.3 m. At 5 m and at 0.3 m, the HT was estimated to be 35° (20–40) and 20° (0–35), respectively. HT following 4 months (3–6) was estimated to be 10° (− 3–20) and 5° (− 5–20); the documented success rates were 74%/96% and 83%/96%. Overcorrection did not happen. No improvement was evident in anomalous head posture components in vertical and frontal planes. Residual motility was estimated to be 30° (10–45). By only 0.037 logMAR, an improvement was noted in the mean BCVA. Infantile nystagmus–related HT is commonly corrected by Kestenbaum surgery. Because Anderson surgery is restricted to bilateral yoke muscle recession, less invasive but comparably effective, high dosage is provided.
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