Secondary hyperfunction of unoperated inferior oblique muscle after surgical treatment of strabismus

1994 ◽  
Vol 88 (2) ◽  
pp. 153-154 ◽  
Author(s):  
Genoveva Alexieva
Author(s):  
N.A. Malinovskaya ◽  
◽  
E.V. Semyonova ◽  
A. Toriya ◽  
P.A. Nikonorova ◽  
...  

Purpose. To study the features of surgical treatment of Brown's syndrome in children. Material and methods. 47 children with Brown's syndrome aged from one to 10 years were treated: 4 children had bilateral form, 43 had congenital form and 4 had acquired form. The operation was performed for 44 children. The indications for surgical treatment were double vision in a straight position, forced position of the head, impaired binocular vision. Results. Three children with acquired Brown's syndrome had a positive effect on the background of conservative treatment. Surgical treatment of Brown's syndrome was effective, but often required repeated interventions (31 patients, 70%): the first stage was weakening of the superior oblique muscle (tenotomy, recession, prolongation), the second stage was recession of the inferior oblique muscle, the third stage was recession of the contralateral inferior rectus muscles (4 patients, 9%). In a number of cases (5 children, 11%), at the outcome of surgical treatment, asymmetry of the palpebral fissures was noted due to mild enophthalmos in the operated eye (the result of weakening of the oblique muscles that «pull» the eyes out of the orbit and weakening of the contralateral inferior rectus muscle that «tightens» the eyeball). Conclusion. Surgery for Brown's syndrome is effective, but often requires reoperation. With acquired forms of Brown's syndrome, examination and the first stage of conservative treatment are required. The absolute indications for surgical treatment of Brown's syndrome are forced head position, double vision in a straight position and impaired binocular vision. Keywords: Brown's syndrome, double vision in a straight position, forced position of the head, impaired binocular vision, surgical treatment.


2016 ◽  
Vol 11 (1) ◽  
pp. 6-8
Author(s):  
Lola Djananovna Babadjanova ◽  
D. U Narzullaeva ◽  
M. K Gopurov

Aim. The objective of the present study was to estimate the effectiveness of the surgical correction of hyperfunction of the inferior oblique muscle in the children depending on the degree of overaction. Materials and methods. We undertook the analysis of hyperactivity of the inferior oblique muscle in 78 children (128 eyes) at the age varying from 4 to 15 years. All the patients were followed up for 9 years. The ophthalmological examination included the determination of vertical deviation with the use of the Hirschberg test and prisms, the study of eyeball movements in 8 gaze directions, the Bielschowsky darkening wedge test, the assessment of the character of vision by means of the Worth's four-dot test, visiometry, dioptos copy, and ophthalmoscopy. Results. The patients underwent myotomy, anterior transposition or myoectomy of the inferior oblique muscle with recession taking into consideration the degree of hyperfunction. Conclusion. Myotomy eliminates vertical deviation only in case of grade 1 overaction. Anterior transposition of the inferior oblique muscle provides an efficient tool for the surgical treatment of the condition being considered because it permits to rapidly correct the large angle of vertical strabismus in the patients presenting with grade 2 or 3 hyperfunction of the inferior oblique muscle. It is recommended to treat grade 4 overaction my means of myoectomy with a recession of up to 10 mm.


2021 ◽  
Author(s):  
Diğdem BEĞENDİ ◽  
Burçin KAYA ◽  
Yaşar DURANOĞLU

Abstract PURPOSE:Bimedial rectus recession is one of the surgical treatment options for infantile esotropia. It is mainly performed with the Hang-Back technique, which has undesirable side effects. In this study, this technique has been modified, and its results are discussed.METHODS:The files of 120 patients followed with the diagnosis of infantile esotropia and treated bimedial rectus muscle recession using the modified Hang-Back technique were reviewed retrospectively. Cases were evaluated by the time of surgery, coexistence with inferior oblique muscle weakening surgery, and presence of refractive error. The factors investigated on the results of surgical treatment were determined as age, gender, amount of hyperopic refractive error, application age, amount of horizontal deviation, amount of recession, stereopsis, fusion, age of surgery.RESULTS:When the cases were divided into subgroups which were the time of surgery, the operation performed with inferior oblique weakening surgery and presence of refractive error; the difference between preoperative and postoperative 1st month, 6th month, and 1st-year angle of deviation was statistically significant in all three groups (p < 0.001).CONCLUSION:This novel technique aims to prevent unwanted movement of the muscle in the horizontal and vertical axis and a gap in the middle of the recessed muscle, seen in the classical Hang-Back technique. The difference between the preoperative and postoperative angle of deviation was statistically significant. Also, over and under-correction and the development of alphabetic pattern deviation were less common in our modified technique.


1979 ◽  
Vol 45 (1) ◽  
pp. 73-78 ◽  
Author(s):  
T. U. Hoogenraad ◽  
F. G. I. Jennekens ◽  
K. E. W. P. Tan

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