Abstract:
PURPOSE:Patients with idiopathic nystagmus syndrome often develop an abnormal head position. A horizontal face turn can be treated with the augmented Kestenbaum procedure, while patients with a chin up or chin down position can be treated with surgery on the vertical recti and/or oblique muscles. Although rare, some patients may have a head tilt with no face turn. We report 5 patients who underwent horizontal transposition of the vertical rectus muscles to correct a head tilt. DESIGN:Retrospective case series. METHODS:Five cases from 2 different tertiary referral eye centers and 3 different surgeons were reviewed and analyzed. Surgery for the patients consisted of either a 7-mm or full tendon-width transposition of the vertical rectus muscles of each eye to induce cyclotorsion in the direction of the head tilt. The presenting clinical histories, measurements, and surgical outcomes were reviewed. The primary outcome measure was correction of head tilt. RESULTS:Of 5 patients, 2 had previous horizontal face turns that were corrected with an augmented Kestenbaum procedure and later developed a head tilt, while 3 patients presented primarily with a head tilt. Age at surgery ranged from 5 to 8 years. Initial tilts were measured between 20-45°. Surgery was performed bilaterally except in 1 patient with history of morning glory disc anomaly and therefore transposition surgery was only performed on fixating eye for that patient. Postoperatively, 3 of 5 patients had near complete (0-5°) resolution of their tilt. One patient had a persistent 5-degree head tilt and a small chin up that was nullified with vertical prisms in spectacles. CONCLUSION:Transposition of the vertical rectus to induce cyclotorsion in the direction of the head tilt improves abnormal head titling in patients who have idiopathic nystagmus syndrome. This procedure was safely performed in patients with previous augmented Kestenbaum procedures with no incidence of anterior segment ischemia in our cases.
journal_name
Am J Ophthalmoljournal_title
American journal of ophthalmologyauthors
de Castro-Abeger A,Benegas NM,Kushner B,Donahue SPdoi
10.1016/j.ajo.2020.04.034subject
Has Abstractpub_date
2020-09-01 00:00:00pages
68-73eissn
0002-9394issn
1879-1891pii
S0002-9394(20)30219-1journal_volume
217pub_type
杂志文章abstract:PURPOSE:To update the biomicroscopic classification and anatomic interpretations of the stages of development of age-related macular hole and provide explanations for the remarkable recovery of visual acuity that occurs in some patients after vitreous surgery. METHODS:Recent biomicroscopic observations of various stag...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
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journal_title:American journal of ophthalmology
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journal_title:American journal of ophthalmology
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journal_title:American journal of ophthalmology
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更新日期:2012-10-01 00:00:00
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更新日期:2017-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:2000-02-01 00:00:00
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journal_title:American journal of ophthalmology
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pub_type: 临床试验,杂志文章
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更新日期:2012-01-01 00:00:00
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更新日期:2002-10-01 00:00:00
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journal_title:American journal of ophthalmology
pub_type: 杂志文章
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更新日期:2008-06-01 00:00:00
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pub_type: 杂志文章
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journal_title:American journal of ophthalmology
pub_type: 杂志文章
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更新日期:2016-12-01 00:00:00