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Kestenbaum procedure with posterior fixation suture for anomalous head posture in infantile nystagmus

Nam Yeo Kang1, Sherwin J Isenberg

  • 1Department of Ophthalmology & Visual Science, Holy Family Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. nyeokang@hanmail.net

Graefe'S Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie
|February 4, 2009
PubMed

Insights

This study shows that combining the Kestenbaum procedure with posterior fixation suture effectively reduces anomalous head posture (AHP) in children with infantile nystagmus. The combined surgery offers a stable solution for improving head alignment.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Strabismus Surgery

Background:

  • Infantile nystagmus often presents with anomalous head posture (AHP).
  • The Kestenbaum procedure and posterior fixation suture are surgical techniques used to address AHP.

Purpose of the Study:

  • To evaluate the efficacy of combining the Kestenbaum procedure with posterior fixation suture for infantile horizontal nystagmus and AHP in children.

Main Methods:

  • Retrospective study of nine consecutive pediatric patients undergoing combined Kestenbaum procedure and posterior fixation suture.
  • Assessment of pre- and postoperative anomalous head posture (AHP), binocular corrected visual acuity (BCVA), and ocular alignment.
  • Minimum 6-month follow-up period.

Main Results:

  • Significant reduction in AHP, with an average decrease of 24.8 degrees (P = 0.008).
  • 78% of patients achieved a residual head turn of 10 degrees or less.
  • No significant change in binocular corrected visual acuity (BCVA) and no development of strabismus.

Conclusions:

  • The combined Kestenbaum procedure and posterior fixation suture is an effective and stable surgical approach for reducing AHP in children with infantile nystagmus.
  • This combined technique is particularly beneficial for AHP in the range of 20 to 35 degrees.
Abstract

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