Новые возможности хирургического лечения паралитического косоглазия у детей

Abstract

Purpose. To assess the clinical effectiveness of the developed surgical method for treating paralytic strabismus. Material and methods. The operation was performed on 32 patients with paralytic strabismus (32 eyes) aged 3 to 12 years. All patients had diplopia in the primary gaze position or in a small abduction. Convergent strabismus was diagnosed in 26 children (81%), divergent strabismus – in 6 patients (19%), in 34% of cases (11 people) strabismus was with a vertical component. Strabismus angle according to Hirshberg before surgery: horizontal deviation from 10 to 30°, vertical – from 5 to 15°. Results. On the 7–10th day after the operation, orthotropy and the appearance of mobility of the eyeball towards the affected muscle were achieved in all operated patients. In the long term (6–12 months) after surgery, 23 children (72%) fully recovered the mobility of the eyeball in 8 directions and formed stable binocular vision, and orthotropy remained. In 9 patients (28%), there was a limitation of the mobility of the eyeball to 5–7°. Conclusion. The proposed method for the surgical treatment of paralytic strabismus makes it possible to achieve in one stage the correction of the deviation angle and the improvement of mobility with the elimination of diplopia, avoids the appearance of postoperative vertical deviation and eliminates large deviation angles. Using the proposed method, it is possible to simultaneously correct both horizontal and vertical deviations. Key words: paralytic strabismus, deviation angle, horizontal deviation, vertical deviation.