scholarly journals The Results of Modified Hang Back Recession Surgery in Infantile Esotropia

2021 ◽  
Author(s):  
Diğdem BEĞENDİ ◽  
Burçin KAYA ◽  
Yaşar DURANOĞLU
Keyword(s):  
Surgical Treatment ◽  
Refractive Error ◽  
Rectus Muscle ◽  
Oblique Muscle ◽  
Modified Technique ◽  
Inferior Oblique Muscle ◽  
Infantile Esotropia ◽  
Time Of Surgery ◽  
Angle Of Deviation ◽  
The Difference

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.

Features of surgical treatment of Brown's syndrome in children

2021 ◽  
pp. 11-16
Author(s):  
N.A. Malinovskaya ◽  
◽  
E.V. Semyonova ◽  
A. Toriya ◽  
P.A. Nikonorova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Binocular Vision ◽  
Rectus Muscle ◽  
Oblique Muscle ◽  
Double Vision ◽  
Inferior Rectus ◽  
Inferior Oblique Muscle ◽  
Straight Position ◽  
Third Stage

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.

scholarly journals Clinical Aspects of Prevention and Management of Primary Inferior Oblique Muscle Overaction

2019 ◽  
Vol 4 (4) ◽  
pp. 77-82
Author(s):  
I. L. Plisov ◽  
V. B. Pushchina ◽  
N. G. Antsiferova ◽  
G. V. Gladysheva ◽  
D. R. Mamulat ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Rectus Muscle ◽  
Functional Results ◽  
Oblique Muscle ◽  
Clinical Aspects ◽  
Inferior Oblique Muscle ◽  
Infantile Esotropia ◽  
Group 2 ◽  
Clinically Significant ◽  
Group 1

Background. Primary inferior oblique muscle overaction (PIOOA) may occur for various reasons and happens to 72 % patients with infantile esotropia. The criterion for the first surgical step is prevalence of vertical or horizontal deviation. The choice of tactics weakening inferior oblique muscle is ambiguous.Aims: to carry out retrospective analysis of PIOOA frequency in patients with infantile esotropia; to assess influence of esodeviation reduction by a surgical, chemodenervational or prismatic method on the existing PIOOA dynamics; to assess clinical and functional results of PIOOA treatment.Methods and methods. The retrospective analysis of 572 patients’ cases lay in assessment of PIOOA frequency and rate in patients with infantile esotropia that manifested under 9 months, with different treatment tactics. The prospective part of the research included two groups of patients. Group 1 (106 patients, 222 eyes) – studying the influence of surgical treatment of PIOOA. Group 2 (127 patients, 207 eyes) – studying the effectiveness of surgical PIOOA treatment. Conclusion. PIOOA frequency in case of different treatment tactics for patients with infantile esotropia is from 17 to 69 %, and the degree of its clinical manifestation is from 1.2 ± 0.4 to 2.6 ± 0.8. Bilateral weakening of medial rectus muscle reduces its probability up to 17–19 %, and the degree of its manifestation up to 1.2 ± 0.4. In cases of combination of PIOOA with infantile esotropia from 20 to 25° with paretic component, it is reasonable to carry out esodeviation reduction by means of bilateral recession, chemorecession or prismatic correction as the first treatment stage, whereas the rate of existing PIOOA is credibly reduced. In cases of choice of tactics, which is necessary for clinically significant reduction or elimination of PIOOA, it is reasonable to carry out chemorecession, marginal partial myotomy or myectomy depending on the PIOOA manifestation.

Bilateral congenital hypertropic strabismus fixus: A case report

2021 ◽  
pp. 112067212098636
Author(s):  
Qingji Li ◽  
Feng Zhou ◽  
Yingying Lu
Keyword(s):  
Case Report ◽  
Special Form ◽  
Rare Case ◽  
Infratemporal Fossa ◽  
Rectus Muscle ◽  
Oblique Muscle ◽  
Bony Landmark ◽  
Inferior Oblique Muscle ◽  
Muscle Belly

Purpose: To report an unusual and rare case of both eyes fixed in an extreme superomedial position. Case report: A case of 48-year-old woman presented with both eyes fixed in an extreme superomedial position; the microcorneas were covered almost completely by the upper eyelids even when she opened her eyes. A forced duction test was performed to confirm there were severe restrictions in all directions. She underwent disinsertion of the superior and medial rectus muscle, inferior oblique muscle belly transposition and sclera fixation. At the 1-year follow-up, there was improved ocular alignment. Conclusion: This case may be a special form of myopic strabismus fixus. The infratemporal fossa may be a bony landmark related to the etiology of global fixation.

scholarly journals Long-term motor and sensory outcomes after surgery for infantile esotropia

2016 ◽  
Vol 73 (5) ◽  
pp. 463-468 ◽  
Author(s):  
Halil Altınsoy ◽  
Gokcen Gokce ◽  
Osman Ceylan ◽  
Fatih Mutlu
Keyword(s):  
Group Iii ◽  
Infantile Esotropia ◽  
Initial Surgery ◽  
Group I ◽  
Additional Surgery ◽  
Angle Of Deviation ◽  
The Difference ◽  
One Year ◽  
The Relationship

Background/Aim. Infantile esotropia (ET), entitled as congenital ET, is defined as an alternating, cross-fixational ET that occurs within the first 6 months of life. The aim of this study was to determine the long-term motor and sensory outcomes after surgical correction of patients with infantile ET. Methods. Medical records of 108 consecutive children who had bimedial rectus recession (BMR) initially for ET were reviewed retrospectively. The patients were divided into 3 groups: the group I, surgery before one-year old; the group II, surgery between one and two-year old; the group III, surgery after two-year old. Results. No significant differences were determined among the groups for preoperative mean angle of deviation and refractive error (p > 0.05, for both). Development rate of dissociated vertical deviation (DVD) was greater (40%) in the group I, and the relationship between the rate of DVD and the timing of the initial surgery was statistically significant (p = 0.03). Risk for additional surgery was significantly greater in patients with a younger mean age at initial surgery (p = 0.01). Although measurable stereopsis rate was higher in the group I (35%, 32.4%, 27.8%, respectively) the difference among the groups was insignificant (p = 0.80). Conclusion. Patients with ET have limited potential of high grade stereoacuity despite the early alignment of eyes. Early surgery also has potential effects for the development of both inferior oblique overaction and DVD earlier.

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