UA32643U - V. yemchenko's technique for surgical treatment of squint with variable deviation angle - Google Patents

Abstract

A technique for the surgical treatment of the squint with the variable deviation angle comprises the fixation of the oculomotor rectus muscle to the sclera behind the eyeball equator using non-absorbable sutures, which are applied to the marginal parts of rectus muscle. These parts of rectus muscle from the sutures to the insertion site are resected. The sutures fix the muscle to the sclera behind the eyeball equator.

Description

Description of the invention

The useful model refers to medicine, namely to ophthalmology and is intended for the operative treatment of 2 strabismus with an unstable angle of deviation.

A well-known method of surgical treatment of strabismus is recession of the horizontal rectus muscles | Guide to eye surgery. Ed. M.L. Krasnova and V.S. Belyaeva. M.: Medicine, 1988. p. 438.|.

The method is carried out as follows. After dissection of the conjunctiva and separation of the muscle, retreating 2 mm from the place of attachment to the sclera, two synthetic sutures are placed on the tendons of the muscle from above and below, each of which 70 takes 1/3-1/4 of the width of the muscle. The threads of the seams are tied. Scissors are used to cut the tendon near the attachment point. The specified amount of recession is measured with a compass and marked on the sclera. Atraumatic needles with sutures that were previously applied to the muscle are passed through the surface layers of the sclera along the marks. The seams are tied in three knots and cut off. Continuous suture on the conjunctiva.

Such an operation reduces or eliminates the deviation in patients with a constant angle of strabismus. However, this operation does not 12 Can eliminate a deviation greater than 109-159, and in case of strabismus with a non-constant angle of deviation, can create an intermittent deviation with the opposite sign.

The closest and chosen as a prototype is a method of surgical treatment called faden-operation or posterior fixation. AITsaz oi Readiyais Orp(NaItis Zygdegu. RNyShadei!irpNia:

MU. V. Zashpdege Sotrapu, 1987. pp. 190-195.1. 20 The method is carried out on rectus muscles as follows. After dissection of the conjunctiva and isolation of the rectus muscle at a distance of 12-1b6mm from the place of its attachment, two non-absorbable sutures are placed on the outer portions of the muscle, after which the muscle is fixed to the adjacent sclera with these sutures. A suture is placed on the conjunctiva.

Such a Faden operation reduces the amplitude of deviation angle fluctuations in patients with strabismus with a non-constant deviation angle and the amplitude of nystagmus. However, this operation cannot eliminate a deviation greater than 105. 25 The basis of a useful model is the task of improving the method of surgical treatment of strabismus with - a non-constant angle of deviation, in which due to suture fixation of the rectus muscle behind the equator of the eyeball to the sclera, the arm of the lever is reduced, that tends to rotate the eyeball, due to the removal of the extreme portions of the rectus muscle from the place of attachment to the sutures, the strength of the muscle decreases, and due to the recession of the remaining middle portion, the area of attachment of the muscle changes, which leads to even greater weakening. ki 3o The task is solved in the method of surgical treatment of strabismus with an unstable angle of deviation, which includes fixing the oculomotor rectus muscle to the sclera behind the equator of the eyeball with non-absorbable sutures, according to a useful model, the extreme portions of the rectus muscle are imposed non-absorbable sutures, and from these sutures to the point of attachment, the extreme portions of the rectus muscle are removed, and the sutures fix the muscle to the sclera at the equator of the eyeball. 35 It is possible that absorbable sutures are applied to the remaining middle portion of the rectus muscle near its attachment site, the portion is cut off and fixed with sutures to the sclera at a certain distance from the previous attachment site.

The declared operation is carried out as follows. Dissection of the conjunctiva in the quadrant corresponding to the muscle 5-7 mm from the limbus parallel to it. The muscle is isolated and fixed on hooks. At a distance of 12-1 mm from the place of its 70 attachment, two non-absorbable sutures are placed on the outer portions of the muscle, each of which captures 1/3 of the width of the muscle. The outer portions of the muscle from these seams to the place of attachment are removed. Then the operation is continued in the following options.

Previously applied sutures fix the muscle to the adjacent sclera at the equator of the eyeball. A continuous suture is applied to the conjunctiva.

To enhance the effect of the operation, a dissolvable suture is placed on the middle portion of the remaining muscle, retreating 2 mm from the place of attachment to the sclera. Scissors cross the middle tendon

With a portion of the muscle near the place of attachment. The specified amount of recession is measured with a compass and marked on the sclera.

According to the mark, the portion is sewn to the sclera with an absorbable suture. The outer portions of the muscle are fixed to the sclera at the equator of the eyeball with non-absorbable sutures. Continuous suture on p» 50 conjunctiva.

Example 1. Patient A., 10 years old. p» Diagnosis: divergence excess.

Objectively: MOSH-1.0

For near - orthotropy; for further - exotropia 30 g. Color test: for close - binocular vision, for further 55, monocular, alternating vision. c On the external rectus muscle of the right eye, the proposed operation in 1 variant was performed. An identical operation was performed on the external rectus muscle of the left eye.

5 months after the operation: MOSH-1.0 in For near and for further - orthotropia. Color test: for near and for further - binocular vision. Recovery.

Example 2. Patient Yu., 4 years old.

Diagnosis: partially accommodative esotropia OB, hypermetropia of a high degree 0).

Objectively:

МО0-0.2 vryzh5.50-0.7 b МО5-0, Zvry5.50-0.8

Esotropia 000-209; from cor. - 102. Color test: monocular vision O5. Refraction of both eyes - hypermetropia Zh

6.50.

On the internal rectus muscle of the right eye, the proposed operation in the 2nd variant was performed, with recession of the middle portion of the BMM.

2 months after surgery:

MO0-0, Zvryn5.50-0.7

MO5-0, Zvry5.50-0.8

Orthotropia, both with and without glasses. Color test: simultaneous vision.

Another year later: 70 МО0-0485рпин5.00-0.9

MO5-0.45rpn5.00-0.9

Orthotropia, both with and without glasses. Color test: stable binocular vision. Recovery.

Thus, the proposed method of operative treatment of strabismus with an unstable angle of deviation allows to eliminate various types of strabismus with an unstable angle of deviation, as well as to increase visual acuity and 7/5 to form full-fledged binocular vision in patients.

Claims (2)

The formula of the invention 1. The method of operative treatment of strabismus with a non-constant angle of deviation, which includes fixing the oculomotor rectus muscle to the sclera behind the equator of the eyeball with non-absorbable sutures, which is distinguished by the fact that non-absorbable sutures are applied to the extreme portions of the rectus muscle , and from these sutures to the place of attachment, the extreme portions of the rectus muscle are removed, and the sutures fix the muscle to the sclera at the equator of the eyeball. 2. The method according to claim 1, which differs in that absorbable sutures are applied to the remaining middle portion of the rectus muscle near the place of its attachment, the portion is cut off and fixed with sutures to the sclera at a certain distance from the previous place of attachment. - Official Bulletin "Industrial Property". Book 1 "Inventions, useful models, topographies of integrated microcircuits", 2008, M 10, 26.05.2008. State Department of Intellectual Property of the Ministry of Education and Science of Ukraine. "I (Se) with Zo "o - with . and? o ko (22) FT» Se p 60 b5