The purpose of this study was to detail clinical and electrophysical outcomes after extraocular muscle surgery in adults with infantile nystagmus syndrome (INS). This was a single centre prospective case series of 81 patients aged 18-72 years (mean 36); 63% male. A surgical algorithm was outlined according to nystagmus type based on abnormal head posture and strabismus type. Follow-up averaged 14 months (13-78). About 80% had associated ocular or systemic diagnosis; 44% with abnormal head position (AHP), 69% strabismic, 79% significant refractive error. Average group mean best corrected visual acuity improved significantly after treatment: 0.55 ±0.16 to 0.41 ±0.11 logMAR. Twenty-three of 38 adults previously ineligible to drive became eligible. There was a significant increase in group mean primary position strabismus angle. Ninety-three percent had postoperative deviations within 10PD horizontal and 6PD vertical. There were no cases of persistent diplopia postoperatively. A significant improvement in AHP was seen postoperatively. Twenty-three of 36 adults (83%) were within 10 degrees of ortho postoperatively. There was a significant increase for contrast sensitivity and NAFX foveation values. The authors acknowledge this as a single centre study but conclude significant and sustained improvement in visual function measures were obtained for adult patients with INS treated by surgery.
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Outcomes after surgery for INS
Reviewed by Fiona Rowe
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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