Outcome study of two standard and graduated augmented modified Kestenbaum surgery protocols for abnormal head postures in infantile nystagmus.
OBJECTIVE
Since Kestenbaum and Anderson, several ophthalmologists have reported the results of different surgical procedures, for abnormal head posture in infantile nystagmus. In this study, we tried to evaluate the surgical results of Parks' original 5-6-7-8 mm modified Kestenbaum procedure and our own 6-7-6-7 mm modified Kestenbaum procedure, designed to reduce some of the problems encountered with other variations of these techniques.


METHODS
Medical records of 92 patients, who had modified Kestenbaum surgery (5-6-7-8 mm or 6-7-6-7 mm) at The Yonsei Medical Center, from March 1991 to September 2001 with a follow-up period of more than 6 months, were reviewed retrospectively. We compared Parks' modified Kestenbaum surgery (5- 6-7-8 mm) performed on 51 patients with our own modified Kestenbaum surgery (6-7-6-7 mm) on 41 patients. Each procedure was done with graded augmentation according to the amount of the face turn and the null point in electro-oculography.


RESULTS
In the follow-up of an average 33 months, 45 out of 51 patients (88.2%) who underwent Parks' modified procedures showed face turn less than 10 degrees. In the follow-up of an average 29 months, 36 out of 41 patients (87.8%) with 6-7-6-7 mm procedure had face turn less than 10 degrees.


CONCLUSIONS
We suggest that 6-7-6-7 mm modified Kestenbaum procedures with a graded augmentation may be a safe and efficient procedure to correct abnormal head posture in infantile nystagmus with a minimum decrease in ocular motility.
Chang
Yoon-Hee
YH
Department of Ophthalmology Ajou University School of Medicine, Suwon, Korea.
Chang
Jee Ho
JH
Han
Sueng-Han
SH
Lee
Jong Bok
JB
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004585:Electrooculography; D005133:Eye Movements; D005260:Female; D019416:Head Movements; D006801:Humans; D008297:Male; D020417:Nystagmus, Congenital / Q000150:complications / Q000601:surgery*; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D011187:Posture; D014102:Torsion Abnormality / Q000601:surgery*; D016896:Treatment Outcome