Тенорафия как альтернатива резекции в лечении горизонтального косоглазия у детей

Abstract

Purpose. To evaluate the effectiveness of surgical treatment of horizontal strabismus by modified tenorrhaphy in comparison with standard resection in children. Material and methods. For 3 years (2017–2019), 560 patients with horizontal strabismus at the age from 2 to 14 years were operated. Of these, 288 patients (51.4%) underwent tenorrhaphy using a modified technique (main group) as augmentation surgery, 272 patients (48.6%) underwent classical resection (control group). Results. The average age of patients in the main group was 6 (3.46) years, in the control group – 5.8 (3.34) years. In the main group of patients, orthotropy was achieved in 85.4% of cases, in the control group – in 83.5% of cases, p = 0.523. The residual strabismus angle (up to 5°) was observed in 40 patients (14%) in the main group and in 44 patients (16.5%) in the control group of patients, p = 0.449. In the main group, additional correction of the residual angle was performed on the day after the operation using adjustable suture in 8 patients (2.8%). Reoperation in the long-term period was required for 10 patients (3.7%) in the control group and 3 patients (0.7%) in the main group, p = 0.039. Significant postoperative conjunctival thickening was found in 7.2% of patients in the main group. Conclusion. The effectiveness of tenorrhaphy is not inferior to classical resection and, in combination with recession (tenomyoplasty), gives predictable stable results. The tenorrhaphy method is technically simpler, safer, more physiological, can be easily corrected in the immediate postoperative period, has no risk of «losing» muscle and can be recommended as an alternative method of resection.