Author(s):Kushner BJ,Gamm DM. Eye muscle surgery for recurrent nystagmus related to head tilt after prior torsional surgery. J AAPOS. 2015 Jun;19(3):211-6. doi: 10.1016/j.jaapos.2015.02.011. PMID 26059663
Journal: Journal Of Aapos : The Official Publication Of The American Association For Pediatric Ophthalmology And Strabismus, Volume 19, Issue 3, Jun 2015
PURPOSE To describe the usefulness of anterior nasal transposition of the inferior oblique muscle in the fixing eye to treat nystagmus-mediated head tilt recurring after prior torsional surgery.
METHODS The medical records of patients who underwent anterior nasal transposition of the inferior oblique muscle in the fixing eye to treat recurrence of head tilt after prior successful torsional surgery were retrospectively reviewed.
RESULTS Three patients met inclusion criteria. In all 3 patients head tilt was eliminated after inferior oblique anterior nasal transposition with 2, 5, and 9.5 years’ follow-up. In no case did surgery result in any further intorsion of the eye. We postulate that the surgery was successful by stabilizing the normal compensatory and anticompensatory torsional movements that occur with head tilt.
CONCLUSIONS Anterior nasal transposition of the inferior oblique muscle effectively treats a recurrent nystagmus-mediated head tilt after prior successful torsional surgery. It does not, however, intort the eye further in this clinical setting and must work via a different mechanism.