Retroequatorial recession of horizontal recti with loop suture in the treatment of congenital nystagmus

Abstract

Purpose The authors wished to evaluate the effectiveness and safety of retroequatorial recession of all four horizontal recti using loop sutures for the treatment of congenital nystagmus. Subjects and methods Twelve patients with congenital nystagmus were enrolled in this prospective study. All patients underwent retroequatorial recession of horizontal recti with loop sutures. All recti were recessed 8mm measuring from the insertion, then the amount of loop suture was determined according to the preoperative ocular alignment of the patients. Electronystagmographic recordings were made in every patient preoperatively and postoperatively as well as an ophthalmological examination. The follow-up period ranged from 6 to 26 months. Results All four horizontal recti were recessed 9 to 12mm including the loop suture (range 1-4mm). Compared to preoperative values, postoperative amplitude and intensity of nystagmus decreased statistically significantly in all patients (p = 0.002). The postoperative decrease in the frequency of nystagmus was not statistically significant (p = 0.173). Improvement of both distance and near visual acuity was achieved in 10 patients. Five of seven patients who had ocular misalignment preoperatively were aligned within 10 PD postoperatively. Improvement in head posture was seen in two of three patients. The authors determined that the improvement in the nystagmus characteristics was most prominent in the immediate postoperative period. Conclusion Retroequatorial recession of all four horizontal recti using loop sutures is a safe and effective procedure for the management of congenital nystagmus.