Method for treating large angles of strabismus

FIELD: medicine.

SUBSTANCE: method involves making incision in conjunctiva. Direct muscle is exposed and separated. Forceps is applied to the separated muscle 4-7 cm far from the place of its attachment to sclera. The muscle is notched to 1/2 of its width 1-2 mm far from the forceps on the proximal side. The muscle is bluntly exfoliated. Muscle flap is turned to after cutting it from sclera. The flap end is sutured to sclera 1-5 mm distal from the previous attachment place. Eyeball is displaced in conjunctival sack to opposite side with respect to the feeble muscle. Interrupted sutures are placed on conjunctiva incision.

EFFECT: enhanced effectiveness in correcting large squint angles.

4 dwg

 

The invention relates to the field of ophthalmic surgery.

There is a method of treatment of strabismus, in which the incision of the conjunctiva, the allocation of direct muscles and separation (see user Manual for eye surgery. Edited Melkassa, Usalama, Moscow: Medicine, 1988, str (method Landolt)).

However, this method has a significant drawback. It is not possible to correct large angles of strabismus for one phase of the operation.

Technical problem: fix large-angle strabismus for one phase of the operation.

The specified technical task is solved in that in the method of treatment of large-angle strabismus, in which the incision of the conjunctiva, the allocation of direct muscles and her separation, then put the clamp on Tsaparang muscle 4-7 mm from the point of attachment to the sclera, the incised muscle at 1-2 mm from the clip on the proximal side of 1/2 of its width, stupidly rasclaat muscle, after removing it from the sclera deploy muscle flap 180° and hem the end of the flap to the sclera of 1-5 mm distal to the previous place of attachment, move the eyeball in the conjunctival SAC in the direction opposite to the weakened muscle and impose nodal stitches in the incision of the conjunctiva.

The method is illustrated in figure 1-4.

The proposed method is as follows.

Treatment of strabismus is what azrise conjunctiva 1 (1), the allocation of direct muscle 2 (figure 2) and its separation.

Then put the clamp 3 (2) Tsaparang muscle 4-7 mm from the point of attachment to the sclera, the incised muscle 4 (2) of 1-2 mm from the clip on the proximal side of 1/2 of its width, stupidly rasclaat muscle 5 (figure 2). Cut the muscle from the sclera. Deploy useprivacy muscle flap 6 (3) 180° and hem the end of the flap to the sclera of 1-5 mm distal to the previous place of attachment 7 (figure 3). Move the eyeball 8 (figure 4) in the conjunctival SAC in the direction opposite to the weakened muscle, and impose nodal joints 9 (figure 4) on the incision of the conjunctiva.

The proposed method is characterized by the following clinical examples.

Example 1. Patient Kanatova Z.B., 51. Before the operation. Visual acuity of the right eye of 0.01, left to 1.0. The right eye is diverted outwards on 30° and up to 15°, restriction to mobility medially and downward. Diagnosis: paralysis diverging from the vertical component of the strabismus, amblyopia deep extent of the right eye.

The patient the operation was performed according to the method proposed by the authors, on both eyes.

After surgery, strabismus angle 0°, limited mobility no.

Example 2. Sick of Kosovo SURDS, 55 years. Visual acuity of the right eye of 0.3, with correction of 0.6, the left - 0,4, with correction of 0.7. The patient strabismus Radvilos is 15 years ago after OCR. Squint operated on the right eye 2 times, left - 4. Before surgery both eyes rejected medially 45°, mobility horizontally absent, the patient is forced head position. Diagnosis: operated paralytic convergent strabismus, paresis of lateral nerves, primary cataracts in both eyes.

The patient the operation was performed according to the method proposed by the authors, on both eyes.

After surgery, strabismus angle 0°0°, mobility eyeballs horizontally within a 20°.

Example 3. Sick of Skirko I.S., 16 years. Visual acuity of both eyes of 1.0. Right eye deviates medially 40° and up to 10°left deviates medially 40°. Both eyes have limited mobility outwards. Diagnosis: paralysis converging vertical component of strabismus in both eyes.

The patient the operation was performed according to the method proposed by the authors, on the right eye.

After surgery, strabismus angle 0°0°slight limitation of motion outwards saved.

Using the proposed method allows to treat large angles of strabismus from 20 to 60°.

The method of treatment of large-angle strabismus, in which the incision of the conjunctiva, the allocation of direct muscles and her separation, characterized in that the further ele is to see the clip on Tsaparang muscle 4-7 mm from the point of attachment to the sclera, the incised muscle at 1-2 mm from the clip on the proximal sideits width, stupidly rasclaat muscle, after removing it from the sclera deploy muscle flap 180° and hem the end of the flap to the sclera of 1-5 mm distal to the previous place of attachment, move the eyeball in the conjunctival SAC in the direction opposite to the weakened muscle, and impose nodal stitches in the incision of the conjunctiva.



 

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FIELD: medicine.

SUBSTANCE: method involves introducing 0.1-0.3 ml of photosensitizing gel preliminarily activated with laser radiation, after having removed neovascular membrane. The photosensitizing gel is based on a viscoelastic of hyaluronic acid containing khlorin, selected from group containing photolon, radachlorine or photoditazine in the amount of 0.1-2% by mass. The photosensitizing gel is in vitro activated with laser radiation having wavelength of 661-666 nm during 3-10 min with total radiation dose being equal to 100-600 J/cm2. The gel is introduced immediately after being activated. To compress the retina, vitreous cavity is filled with perfluororganic compound or air to be further substituted with silicon oil. The operation is ended with placing sutures on sclerotomy and conjunctiva areas. Compounds like chealon, viscoate or hyatulon are used as viscoelastic based on hyaluronic acid. Perfluormetylcyclohexylperidin, perfluortributylamine or perfluorpolyester or like are used as the perfluororganic compound for filling vitreous cavity.

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EFFECT: complete destruction of neoplasm; excluded tumor recurrence; reduced risk of tumor cells dissemination.

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