Эффективность тенорафии в лечении горизонтального косоглазия у детей

Abstract

Aim. Evaluation of the effectiveness of the modified tenorrhaphy method in comparison with standard resection in children in the surgical treatment of horizontal strabismus. Methods. In the period from 2017 to 2019, we operated 560 patients with horizontal strabismus aged 2 to 14 years. Of these, 288 patients underwent tenorrhaphy modified by us (main group), 272 patients underwent classical resection (the control group). In small and medium angles of strabismus, a strengthening operation was performed simultaneously on one eye in combination with a recession of the antagonist muscle. In large angles of strabismus, the reinforcing operation was performed with tenomyoplasty. Results. In main group, the state of orthotropy was achieved in 85.4 % of cases (246/288 patients), in control group – in 83.5 % of cases (227/272 patients), p = 0.523 (statistical difference is not significant). A residual angle of strabismus up to 5 ° was observed in 40 patients (14 %) in main group and in 44 patients (16.5 %) in control group, p = 0.449 (statistical difference is not significant). Conclusions. Tenorrhaphy according to our modified technique is not inferior to classical resection in efficiency and, in combination with recession (tenomyoplasty) of the antagonist muscle, gives stable predictable results. The tenorrhaphy method is safer, technically simpler, has no risk of «losing» the muscle, more physiological since there is no cutting of the muscle from the attachment site and blood supply disorders in the anterior segment of the eye; it is easy to correct in the immediate postoperative period. Key words: tenorrhaphy; fold; strabismus; children.