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Surgical Management of Concurrent Strabismus and Face Turn in Patients with Infantile Nystagmus
얼굴돌림 및 사시를 동반한 영아안진에서 Adjusted Kestenbaum 술식의 효과
JKOS 2019 Aug;60(8):780-6
Published online August 15, 2019;  https://doi.org/10.3341/jkos.2019.60.8.780
Copyright © 2019 The Korean Ophthalmological Society.
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Sung Eun Park, MD1, Sueng-Han Han, MD2, Jong Bok Lee, MD2,3, Jinu Han, MD1
박성은1 · 한승한2 · 이종복2,3 · 한진우1

The Institute of Vision Research, Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine1, Seoul, Korea
The Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine2, Seoul, Korea
Kong Eye Hopistal3, Seoul, Korea
연세대학교 의과대학 강남세브란스병원 안과학교실 시기능개발연구소1, 연세대학교 의과대학 세브란스병원 안과학교실 시기능개발연구소2, 공안과3
Received February 20, 2019; Revised April 16, 2019; Accepted July 18, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Purpose: To investigate the effect of adjusted Kestenbaum surgery in patients with idiopathic infantile nystagmus who were affected by both strabismus and face turn.
Methods: This retrospective consecutive case series included 12 patients with infantile nystagmus who had face turn and strabismus. All patients underwent adjusted Kestenbaum surgery between 1996 and 2014, and primary outcome measures were the postoperative degree of face turn and strabismus.
Results: All patients had jerky nystagmus with compensatory face turn and strabismus. Of the 12 patients, eight patients were exotropes and four patients were esotropes. The mean age at surgery was 12.5 ± 10.7 years (range, 2-36 years). The mean postoperative follow-up was 17.8 ± 12.0 months (range, 7-43 months). Surgery was successful in eight (66.7%) out of 12 patients. Improvement of anomalous head posture was satisfactory in all patients, but an angle of deviation within 10 prism diopters was not achieved in four patients.
Conclusions: Adjusted Kestenbaum surgery simultaneously improved both ocular misalignment and face turn with one-stage surgery. Two or three rectus muscles surgery can be considered in these patients because it is not only simpler than four muscles surgery but also can preserve one or two rectus muscles.
Keywords : Infantile nystagmus, Nystagmus, Oculomotor muscles, Strabismus

 

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