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Impressum
Surgical Nystagmus Treatment - clinical and electronystagmographic Observations in congenital Nystagmus
Celic M., Dorn V.
Department of Ophthalmology, Faculty of Medicine, Clinical Hospital Center, Kišpaticeva 12, HR 10000 Zagreb, Croatia
In the operative treatment of congenital ocular nystagmus it is possible,
with surgical procedures, according to Kestenbaum, Anderson and Cüppers,
eccentic neutral zone of nystagmus to shift in the primary position of
gaze. Herewith is torticollis corrected, visual acuity in straight ahead
direction is better, and nystagmus intensity is reduced.
Patients and Methods: The study is retrospective analysis of clinical
and electornystagmografic (ENG) findings of 47 patients with congenital
ocular nystagmus mostly without strabismus and with nystagmus neutral
zone in horizontal direction operated in our ophthalmological department
during 33 years, from 1967 to 2000. The clinical findings, head position,
nystagmus "null point", ocular deviation, visual acuity and
binocular vision were before and after treatment analysed. Electronystagmographic
assessment for the part of patients, included the morphologic analysis
of nystagmus, neutral zone and nystagmus intensity, depending on eye position
before and afer surgery was also performed.
Results: The majority of patients was treated at the age of eight.
Nystagmus neutral zone was in horizontal direction in 29 patients. Less
pronounced oblique head tilt had 18 patients. Of the 29 patients had neutral
zone of nystagmus to the right side, 16 had neutral zone to the left.
The majority of patients was operated according to Anderson (27). All
patients had the refractive errors. The hypermetropic astigmatism was
the most frequent. Binocular visual acuity 6/10 - 6/8 in compensatory
head tilt, before the surgery had 13 patients and after surgery it has
been acchieved in 34 patients in straight ahead position or in smaller
compensatory head posture.
Conclusions: The best results attained the patients with neutral
zone in horizontal direction and the patients with preoperative good visual
acuity in compensatory head posture, without higher refractive errors
and without pathologic fundus changes.