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R. W. Hertle, D. Yang, J. Jeng, K. Carey, E. Mitchell; Classification and Results of Eye Muscle Surgery in 100 Patients with Infantile Nystagmus Syndrome. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1999.
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To report a systematic approach to eye muscle surgery and the visual and elctrophysioloigcal effects of eye muscle surgery in 100 patients with infantile nystagmus syndrome (INS).
Prospective, interventional case cohort analysis of clinical and eye movement data in 100 patients with INS who had virgin extraocular eye muscles operated on for combinations of strabismus, an anomalous head posture and nystagmus. All patients were followed at least 9 months after surgery. Outcome measures, part of an IRB approved study, included visual acuity, head position, strabismic deviation, and eye movement recordings, from which waveform types and the nystagmus optimmal foveation function (NOFF) and/or an Expanded Nystagmus Acuity Function (eNAFX) . Computerized parametric and non-parametric statistical analysis of data were perfomed using standard software on both individual and group data.
There were 9 consistent surgical procedures used with the most common being that for a horizontal head posture alone (20%). Age at surgery averaged 11 yrs with 14 mos follow up. 68% had associated eye disease (optic nerve, retinal, amblyopia, cataracts) . Group means in binocular acuity (p<0.05), strabismic deviation (p<0.05), head posture (p<0.001), and the NOFF/eNAFX measures (p < 0.01) from eye movement recordings improved in all patients. There was a consistent change in null zone waveforms to more favorable jerk types. There were 12 (12%) reoperations without any serious surgical complications.
Using this approach, surgery on the extraocular muscles in patients with INS results in improvements in multiple aspects of ocular motor and visual function.1. (144/A214) Foveation and Acuity Deficits in Infants and Children With Infantile Nystagmus Syndrome ARVO Annual Meeting 2009(Sunday, Apr 27 2008 8:30 AM - 10:15 AM) J. Felius, V.L.N. Fu, L.M. Wyatt, R.W. Hertle, E.E. Birch2. Hertle RW, Yang D. Clinical and electrophysiological effects of extraocular muscle surgery on patients with Infantile Nystagmus Syndrome (INS). Semin Ophthalmol. 2006 Apr-Jun;21(2):103-10.
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