Dosed surgical treatment of vertical strabismus using the technique of anterior transposition of the inferior oblique muscle

Autor: A. V. Tereshchenko, I. G. Trifanenkova, A. A. Vydrina, M. S. Tereshchenkova
Jazyk: ruština
Rok vydání: 2019
Předmět:
Zdroj: Офтальмохирургия, Vol 0, Iss 3, Pp 36-43 (2019)
Druh dokumentu: article
ISSN: 0235-4160
2312-4970
DOI: 10.25276/0235-4160-2019-3-36-43
Popis: Purpose. To develop a technology for dosed surgical treatment of vertical strabismus caused by hyperfunction of the inferior oblique muscle of varying severity, using the technique of anterior transposition of the inferior oblique muscle and to ev aluate its effectiveness.Material and methods. The study included 228 patients (228 eyes) with vertical strabismus caused by hyperfunction of the inferior oblique muscle. Depending on the method of surgical treatment, the patients were divided into two groups. Group 1 (core group) included 112 patients (112 eyes) who underwent surgical treatment using our modified dosing technique for the degree of anterior transposition of the inferior oblique muscle. Group 2 (control group) included 116 patients (116 eyes) who were treated according to the classical method of dosed recession with degrees from «+1» to «+3» and transposition of the inferior oblique muscle with a degree of «+4». In each group, two subgroups were distinguished: subgroup a (with hypertrophy in adduction less than 7° according to Girshberg) and subgroup b (with hypertropy in adduction more than 7°). The follow-up was 1 day, 1, 3, 6, 12, 24 months after sur gery.Results. At the end of the observation period in all patients of group 1 Bilshovsky’s test w as negative. In group 2, in cases of persisting hypertropia in the primary position of the eye, in subgroup 2A (6.4%) and subgroup 2B (10.1%), a positive Bilshovsky test on the side of the hypertropic eye was detected, which indicated a hypoeffect of surgical treatment. The frequency of binocular vision formation was higher in subgroup 1a (68%) than in subgroup 2a (42.5%). Similar results were obtained in subgroups b: the frequency of binocular vision formation at the end of the observation period in subgroup 1b was 59.7%, in subgroup 2b it was 46.4%.Conclusion. The developed modification of the surgical treatment of hyperfunction of the inferior oblique muscle depending on the magnitude of the angle of vertical deviation using the method of dosed anterior transposition of the inferior oblique muscle allows to achieve high anatomical and functional results at vertical angles of deviation in adduction over 7° in Girshberg, as well as in cases of small angles to 7° across Girshberg.
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