A NEW APPROACH TO THE DOSING DEGREE OF ANTERIOR TRANSPOSITION OF THE INFERIOR OBLIQUE MUSCLE SURGERY FOR VERTICAL STRABISMUS

Introduction. Strabismus is the  deviation  of one  eye from  a  common  fixation point, associated  with impaired  of binocular  vision. The eye’s position in horizontal and vertical directions looking straight determines the t ype of strabismus. Despite  numerous reports of surgical  interventions on the  vertical action  muscles, there is no a differentiated approach to the  treatment of patients with this pathology. The search for the optimal methods and principles of surgical  treatment of vertical strabismus caused by hyperfunction  of the inferior oblique muscle, testifies to the relevance of developing new approaches to eliminate hypertropia  depending  on its severit y.

The purpose — to  develop  a  method  of dosing  the  degree of anterior transposition of the  inferior  oblique muscle  in the  surgical treatment of vertical  strabismus caused by hyperfunction  of the  inferior oblique muscle  depending  on severit y,  and  to  evaluate  its clinical efficacy.

Patients And Methods. In the  period  from January 2013 to October  2015 60 children  (96  eyes) aged  from 3 to 17 years  with a vertical strabismus caused by hyperfunction  of the inferior oblique muscle  were  followed-up. All patients underwent a complete pre  — and postoperative examinations. All patients received  surgical  treatment — weakening  of the inferior oblique muscle through  its anterior dosed  transposition.

Results. There  were  no intraoperative complications and  specific complications t ypical for weakening  surgeries on the  inferior oblique muscle. Overcorrection  wasn’t  registered neither  in the  case of surgical  treatment of large vertical angles  of strabismus, no small vertical deviations.  Restriction of mobilit y of the eyeballs wasn’t recorded throughout the observation period  in any patient. Residual  hyperfunction  of the  inferior oblique muscle  was  in 3 patients (5%). It did not exceed  the value of the  vertical,  with the  fusion and  did not  require  additional surgical  treatment.

Conclusion. The technology  will significantly improve  the  efficiency and  safet y  of treatment, reduce the  risk  of complications and  the  duration  of surgery and  anesthesia, the number of surgical treatment stages, to create optimal conditions  for the rehabilitation  of visual functions  in children.

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