A novel new [yet again] procedure for correction of compensatory head posture in infantile nystagmus; augmented anderson plus dell'osso-hertle.

PURPOSE: To evaluate the effectiveness of an augmented Anderson procedure combined with tenotomy and reattachment of the remaining horizontal rectus muscles in correcting horizontal compensatory head posture associated with idiopathic infantile nystagmus. METHODS: Clinical records of five subjects with horizontal compensatory head posture secondary to infantile nystagmus who underwent an augmented Anderson procedure combined with tenotomy and reattachment of the remaining horizontal rectus muscles were retrospectively reviewed. The main outcome measures were angular reduction of head turn, nystagmus reduction, and visual acuity. RESULTS: The mean preoperative head deviation of 19.6 degrees decreased 79% to a postoperative mean of 4.2 degrees. No patient was overcorrected. Nystagmus was decreased in four of five subjects. Visual acuity improved by one Snellen line or more in three eyes, improved less than one Snellen line in two eyes, and was unchanged in five eyes. CONCLUSIONS: An augmented Anderson procedure combined with tenotomy and reattachment of the remaining horizontal rectus muscles is safe and effective in reducing both abnormal compensatory head posture and nystagmus in idiopathic infantile nystagmus with minimal risk of overcorrection.