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Modified Anderson Procedure in Infantile Nystagmus with Face Turn within 30 Degrees
30° 이내의 얼굴돌림을 보인 영아눈떨림환자에서 Modified Anderson 술식
JKOS 2019 Jun;60(6):569-74
Published online June 15, 2019;
Copyright © 2019 The Korean Ophthalmological Society.
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Sang Cheol Yang, MD1, Hyeshin Jeon, MD1,2, Hee Young Choi, MD, PhD1,2

Department of Ophthalmology, Pusan National University School of Medicine1, Yangsan, Korea
Biomedical Research Institute, Pusan National University Hospital2, Busan, Korea
부산대학교 의과대학 안과학교실1, 부산대학교병원 의생명연구원2
Received January 10, 2019; Revised February 16, 2019; Accepted May 17, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: To evaluate the efficacy of modified Anderson procedure in infantile nystagmus with face turn less than 30 degrees.
Methods: This study was a retrospective review of the medical records of 13 consecutive patients who underwent a modified Anderson procedure for abnormal head position in infantile nystagmus at Pusan National University hospital from February 2002 to March 2017. We compared best-corrected visual acuity (logarithm of minimal angle of resolution, logMAR), refraction, degree of face turn, ocular motility, and angle of deviation preoperatively and at 1 week postoperatively, 6 months postoperatively, and the final visit. Recession of the yoke rectus muscles responsible for the slow phase of nystagmus was performed, depending on the direction of face turn; the medial rectus muscle of the eye to which the head was turned was recessed 10 mm, whereas the lateral rectus muscle of the contralateral eye was recessed 12 mm.
Results: The mean age of the patients was 8.9 (2-25) years, and the mean follow-up period after surgery was 51.3 (6-183) months. Twelve patients (92.3%) had no residual head posture or <10° at 6 months postoperatively, and three patients (23.1%) achieved this outcome with an additional operation. The mean degrees of face turn were 22.30° before surgery and 3.85° postoperatively (p = 0.001). Best-corrected visual acuity (logMAR) was 0.41 in the better eye and 0.50 in the worse eye before surgery; this improved to 0.34 and 0.45 at 6 months postoperatively (p = 0.068 and p = 0.228, respectively). Despite the large recessions involved, only one patient showed mild limitation of abduction after surgery.
Conclusions: The modified Anderson procedure may be effective for correcting abnormal head position in infantile nystagmus with face turn less than 30 degrees; patients were not overcorrected.
Keywords : Abnormal head position, Modified Anderson procedure, Nystagmus


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