To evaluate the efficacy of modified Anderson procedure in infantile nystagmus with face turn less than 30 degrees.

This study was a retrospective review of the medical records of 13 consecutive patients who underwent a modified Anderson procedure for abnormal head position in infantile nystagmus at Pusan National University hospital from February 2002 to March 2017. We compared best-corrected visual acuity (logarithm of minimal angle of resolution, logMAR), refraction, degree of face turn, ocular motility, and angle of deviation preoperatively and at 1 week postoperatively, 6 months postoperatively, and the final visit. Recession of the yoke rectus muscles responsible for the slow phase of nystagmus was performed, depending on the direction of face turn; the medial rectus muscle of the eye to which the head was turned was recessed 10 mm, whereas the lateral rectus muscle of the contralateral eye was recessed 12 mm.

The mean age of the patients was 8.9 (2–25) years, and the mean follow-up period after surgery was 51.3 (6–183) months. Twelve patients (92.3%) had no residual head posture or <10° at 6 months postoperatively, and three patients (23.1%) achieved this outcome with an additional operation. The mean degrees of face turn were 22.30° before surgery and 3.85° post-operatively ( p = 0.001). Best-corrected visual acuity (logMAR) was 0.41 in the better eye and 0.50 in the worse eye before surgery; this improved to 0.34 and 0.45 at 6 months postoperatively ( p = 0.068 and p = 0.228, respectively). Despite the large recessions involved, only one patient showed mild limitation of abduction after surgery.

The modified Anderson procedure may be effective for correcting abnormal head position in infantile nystagmus with face turn less than 30 degrees; patients were not overcorrected.