Abstract: Objective    To explore the surgical method and effect of infantile nystagmus syndrome (INS) with strabismus. Methods    In this retrospective study, we reviewed 11 cases of INS with strabismus underwent surgeries in the department of ophthalmology of Shandong Provincial Hospital affiliated to Shandong University between April 2011 and December 2012. All children were in accordance with inclusive criteria and with a minimum postoperative follow-up of 6 months. Corrected visual acuity, anomalous head postures(AHP), ocular alignment and stereoacuity were examined at both pre-operative and post-operative time. For nystagmus children with strabismus, a recession-resection procedure should be performed on the dominant fixating eye; the amount of recession-resection procedure on the nondominant eye was adjusted to account for the strabismus. Results    A total of 11 children with 6 extropic and 5 esotropic were included. The mean age was 9.0±4.7 years (range, 5 to 15 years). The mean follow-up time was 9.4±5.3 months. At last post-operative follow-up time, 5 children of AHP were cured, 9 children of  ocular alignment was orthophoria and 2 children were under-corrected; 6 children of binocular vision acuity were improved more than 2 levels, and 4 children of binocular vision acuity were improved 1 level, and only one child of binocular vision acuity had no change. Conclusion    For INS children with strabismus, surgery should be performed on the dominant fixating eye; surgery on the nondominant eye is adjusted to account for strabismus. The surgery is not only to correct AHP and ocular alignment but also to improve binocular vision acuity.

Key words: Nystagmus, Anomalous head postures, Strabismus, Vision acuity, Ocular alignment