title: Eye muscle surgery for recurrent nystagmus related to head tilt after prior torsional surgery.
abstract: OBJECTIVE
  To describe the usefulness of anterior nasal transposition of the inferior oblique muscle in the fixing eye to treat nystagmus-mediated head tilt recurring after prior torsional surgery.
  
  
  METHODS
  The medical records of patients who underwent anterior nasal transposition of the inferior oblique muscle in the fixing eye to treat recurrence of head tilt after prior successful torsional surgery were retrospectively reviewed.
  
  
  RESULTS
  Three patients met inclusion criteria. In all 3 patients head tilt was eliminated after inferior oblique anterior nasal transposition with 2, 5, and 9.5 years' follow-up. In no case did surgery result in any further intorsion of the eye. We postulate that the surgery was successful by stabilizing the normal compensatory and anticompensatory torsional movements that occur with head tilt.
  
  
  CONCLUSIONS
  Anterior nasal transposition of the inferior oblique muscle effectively treats a recurrent nystagmus-mediated head tilt after prior successful torsional surgery. It does not, however, intort the eye further in this clinical setting and must work via a different mechanism.
authors.affiliation: Department of Ophthalmology & Visual Sciences, University of Wisconsin, Madison. Electronic address: bkushner@wisc.edu.
authors.forename: Burton J
authors.initials: BJ
authors.lastname: Kushner
authors.affiliation: Department of Ophthalmology & Visual Sciences, University of Wisconsin, Madison; McPherson Eye Research Institute, University of Wisconsin, Madison.
authors.forename: David M
authors.initials: DM
authors.lastname: Gamm
mesh_terms: D002648:Child; D005260:Female; D006257:Head; D006801:Humans; D008297:Male; D009759:Nystagmus, Pathologic / Q000209:etiology / Q000601:surgery*; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D011187:Posture; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D014102:Torsion Abnormality / Q000601:surgery; D055815:Young Adult