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Effects of augmented tenotomy and reattachment in the infantile nystagmus syndrome.
Digit J Ophthalmol. 2016; 22(1):12-24.DJ

Abstract

PURPOSE

To test the hypothesis that augmented tenotomy and reattachment surgery (AT-R), which involves placing an additional suture in each distal tendon during the 4-muscle tenotomy and reattachment (T-R) or other infantile nystagmus syndrome (INS) procedures, could increase the beneficial effects of many types of extraocular muscle (EOM) surgery to treat INS.

METHODS

Both infrared reflection and high-speed digital video systems were used to record the eye movements in 4 patients with INS before and after AT-R surgery. Data were analyzed using the eXpanded Nystagmus Acuity Function (NAFX) that is part of the OMtools software.

RESULTS

Placement of the augmentation suture did not interfere with Kestenbaum, Anderson, bilateral medial rectus muscle recession, or T-R surgeries. The therapeutic effects of AT-R were similar to but not equal to those from the traditional single-suture surgeries (ie, broadening longest foveation domain [LFD] but no improvement of NAFX peak). The average of the NAFX percent improvements after AT-R was within 31% of those estimated from NAFX values before T-R; the average of the percent broadenings of the LFD values after AT-R was within 16%.

CONCLUSIONS

The AT-R does not improve the foveation quality in INS above the traditional T-R surgery. It is not improved by an additional suture; indeed, some improvements may be diminished by the added suture. The hypothesized augmented-tendon suture technique (sans tenotomy) has been modified and remains to be tested.

Authors+Show Affiliations

Daroff-Dell'Osso Ocular Motility Laboratory, Louis Stokes Cleveland Department of Veterans Affairs Medical Center and CASE Medical School, Cleveland, Ohio;; Departments of Neurology, Ophthalmology, Cleveland, Ohio.Departments of Biomedical Engineering, Cleveland, Ohio.Daroff-Dell'Osso Ocular Motility Laboratory, Louis Stokes Cleveland Department of Veterans Affairs Medical Center and CASE Medical School, Cleveland, Ohio;; Departments of Neurology, Ophthalmology, Cleveland, Ohio; Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27330478

Citation

Dell'Osso, Louis F., et al. "Effects of Augmented Tenotomy and Reattachment in the Infantile Nystagmus Syndrome." Digital Journal of Ophthalmology : DJO, vol. 22, no. 1, 2016, pp. 12-24.
Dell'Osso LF, Orge FH, Jacobs JB. Effects of augmented tenotomy and reattachment in the infantile nystagmus syndrome. Digit J Ophthalmol. 2016;22(1):12-24.
Dell'Osso, L. F., Orge, F. H., & Jacobs, J. B. (2016). Effects of augmented tenotomy and reattachment in the infantile nystagmus syndrome. Digital Journal of Ophthalmology : DJO, 22(1), 12-24. https://doi.org/10.5693/djo.01.2016.01.002
Dell'Osso LF, Orge FH, Jacobs JB. Effects of Augmented Tenotomy and Reattachment in the Infantile Nystagmus Syndrome. Digit J Ophthalmol. 2016;22(1):12-24. PubMed PMID: 27330478.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of augmented tenotomy and reattachment in the infantile nystagmus syndrome. AU - Dell'Osso,Louis F, AU - Orge,Faruk H, AU - Jacobs,Jonathan B, Y1 - 2016/03/31/ PY - 2016/01/13/accepted PY - 2016/6/23/entrez PY - 2016/6/23/pubmed PY - 2017/3/30/medline SP - 12 EP - 24 JF - Digital journal of ophthalmology : DJO JO - Digit J Ophthalmol VL - 22 IS - 1 N2 - PURPOSE: To test the hypothesis that augmented tenotomy and reattachment surgery (AT-R), which involves placing an additional suture in each distal tendon during the 4-muscle tenotomy and reattachment (T-R) or other infantile nystagmus syndrome (INS) procedures, could increase the beneficial effects of many types of extraocular muscle (EOM) surgery to treat INS. METHODS: Both infrared reflection and high-speed digital video systems were used to record the eye movements in 4 patients with INS before and after AT-R surgery. Data were analyzed using the eXpanded Nystagmus Acuity Function (NAFX) that is part of the OMtools software. RESULTS: Placement of the augmentation suture did not interfere with Kestenbaum, Anderson, bilateral medial rectus muscle recession, or T-R surgeries. The therapeutic effects of AT-R were similar to but not equal to those from the traditional single-suture surgeries (ie, broadening longest foveation domain [LFD] but no improvement of NAFX peak). The average of the NAFX percent improvements after AT-R was within 31% of those estimated from NAFX values before T-R; the average of the percent broadenings of the LFD values after AT-R was within 16%. CONCLUSIONS: The AT-R does not improve the foveation quality in INS above the traditional T-R surgery. It is not improved by an additional suture; indeed, some improvements may be diminished by the added suture. The hypothesized augmented-tendon suture technique (sans tenotomy) has been modified and remains to be tested. SN - 1542-8958 UR - https://www.unboundmedicine.com/medline/citation/27330478/Effects_of_augmented_tenotomy_and_reattachment_in_the_infantile_nystagmus_syndrome_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/27330478/ DB - PRIME DP - Unbound Medicine ER -