Orbital implantation of biocompatible magnets for the treatment of intractable nystagmus

Abstract

SummaryIntractable acquired nystagmus causes debilitating symptoms and medical and surgical treatment is typically unsatisfactory. We describe a pilot study in which pairs of custom‐designed titanium‐encased magnets were sequentially implanted in an adult male patient with recalcitrant vertical nystagmus to achieve a reversible dampening of the nystagmus in the primary position. Under general anaesthesia, one magnet was sutured within the inferior retractor sheath, and, with the globe in the primary position, the fellow magnet was secured to the orbital floor with histoacryl glue, thereby dampening the nystagmus. The procedure was repeated on the fellow orbit several weeks later. This pilot study on a single patient was completed without complication, and has achieved a dramatic improvement in objective and subjective visual functions, including the spatial distribution of eye position during fixation in the primary position, together with a marked subjective improvement in quality of life. NIHR funding has been secured to extend this study to a larger cohort of patients to determine the extent and duration of this dampening effect in a larger cohort of patients.