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The authors performed a recession of yoked muscles in patients with idiopathic infantile nystagmus (IIN) in a graded manner based on the amount of head turn. This was a retrospective case series of 37 patients; 26 males, 11 females aged 12.39 ±8.66 years at time of surgery. Two had exotropia in primary gaze and surgery was adjusted to account for the angle. One needed reoperation for residual abnormal head posture. Amount of recessions was based on head turn measurements. All patients showed improvement in head posture reducing from 22.5 ±6.12 degrees to 7.58 ±3.62 degrees at one month postop. Mean binocular visual acuity improved from 0.47 ±0.15 to 0.25 ±0.17 logMAR. All patients were orthotropic at review with no ocular motility restrictions. Both cases with strabismus achieved good alignment. The authors conclude that augmented / modified Anderson procedure is a good surgical choice for abnormal head posture correction and allows reversal or further adjustment if needed.

Clinical evaluation of graded Anderson’s procedure in idiopathic infantile nystagmus.
Ganesh SC, Rao SG, Narendran K.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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