Effect of four-muscle tenotomy and reattachment on fusion maldevelopment nystagmus syndrome.

Dr. Nelson has no financial or proprietary interest in the materials presented herein. doi: 10.3928/01913913-20140507-02 Prior to 2000, there was no surgical treatment for patients with nystagmus who did not have associated strabismus or an eccentric gaze angle and null position. Positive therapeutic effects of the four-muscle tenotomy and reattachment procedure, including a generalized broadening of the null position and an improvement in central vision, have been demonstrated by a variety of investigators. The results have been documented by extensive eye movement recordings. It is currently an accepted treatment option for those patients, and although it is being performed throughout the United States and worldwide, it is primarily performed in only a few academic centers. Further clinical studies will be necessary to show the positive effects of the fourmuscle tenotomy and reattachment in patients with or without the fusion maldevelopment nystagmus syndrome and associated anomalous head posture or strabismus.