Muralidhar Rajamani, Ramamurthy Dandapani
Department of Pediatric Ophthalmology and Strabismus, The Eye Foundation, Coimbatore, Tamil Nadu, India.
J Curr Ophthalmol. 2021 Oct 22;33(3):330-335. doi: 10.4103/2452-2325.329065. eCollection 2021 Jul-Sep.
To report the results of plication augmentation of the augmented Anderson procedure in patients with infantile nystagmus syndrome and face turn.
In this retrospective study, all patients who underwent plication augmentation of the augmented Anderson procedure between August 2015 and November 2018 were included. Our study included patients older than 6 years with a face turn >25°. We also included patients with residual face turns ≥15° after Anderson-type procedures. The face turn was measured by a goniometer and also quantified with prisms placed with apex in the direction of the face turn. We plicated the medial rectus of one eye by 5.0 mm and lateral rectus of the fellow eye by 7.0 mm based on the direction of the face turn in addition to the augmented Anderson procedure. Patients were reviewed on the 1 postoperative day, 1 month, and every 6 months thereafter.
Eight patients with a mean face turn of 27.5° ± 6.5° underwent plication augmentation of the augmented Anderson procedure. Two patients had residual face turns after a previous Anderson-type procedure. We obtained a mean correction of 25° ± 6.5° with a median prismatic correction of 45 prism diopters (PD) for each eye. The median face turn at the last review was 2.5°, and all patients were corrected to within 10°. Excluding patients operated for residual face turns, we had a mean dose response of 2.7 PD/mm and 1.7°/mm of surgery on each eye. Five patients had an improvement in null zone visual acuity. Two patients had a restriction in ocular motility of -2 in the direction of the recessed extraocular muscle at the last review, and the remaining had a -1 restriction.
Plication augmentation of the augmentation Anderson procedure appears to be a safe and effective procedure for patients with infantile nystagmus syndrome and a face turn more than 25°. It may also be used for residual face turns more than 15°.
报告在患有婴儿型眼球震颤综合征且有面转的患者中，对改良安德森手术进行襻增强术的结果。
在这项回顾性研究中，纳入了2015年8月至2018年11月期间接受改良安德森手术襻增强术的所有患者。我们的研究包括年龄大于6岁且面转>25°的患者。我们还纳入了安德森式手术后仍有≥15°残余面转的患者。使用量角器测量面转，并通过将棱镜顶角置于面转方向来进行量化。除改良安德森手术外，我们根据面转方向对一只眼的内直肌襻入5.0毫米，对另一只眼的外直肌襻入7.0毫米。术后第1天、1个月及此后每6个月对患者进行复查。
8例平均面转为27.5°±6.5°的患者接受了改良安德森手术的襻增强术。2例患者在先前的安德森式手术后仍有残余面转。我们平均矫正了25°±6.5°，每只眼的棱镜矫正中位数为45棱镜度（PD）。末次复查时面转的中位数为2.5°，所有患者均被矫正至10°以内。排除因残余面转而接受手术的患者，每只眼手术的平均剂量反应为2.7 PD/毫米和1.7°/毫米。5例患者的中和带视力有所改善。末次复查时，2例患者在眼外肌后徙方向的眼球运动受限为-2，其余患者为-1受限。
对于患有婴儿型眼球震颤综合征且面转超过25°的患者，改良安德森手术的襻增强术似乎是一种安全有效的手术。它也可用于残余面转超过15°的情况。
