Substantiation of the tactics of recurrent surgical interventions in the surgical treatment of concomitant strabismus

Abstract

Aim. To substantiate the recommendations on the tactics of recurrent operations for strabismus in children on the basis of histological investigation of the fragments of «weakened» muscles. Methods. Conducted was a retrospective analysis of recurrent surgical treatment of 2 patients with concomitant convergent strabismus. In order to determine the cause of dysfunction of the muscles conducted was a histological study of 80 fragments of the lateral rectus muscles, which were excised during surgical treatment of convergent strabismus. Results. Muscle fibers were found only in the distal sections during the resection of the lateral rectus muscles at a distance of 8.5-9 mm. Taking into consideration the fact that at point were the muscle transitions into the tendon located are the palisade nerve endings, which may play the major role in the contraction process, the exceedence of the above mentioned amount of muscle resection during strabismus surgery is dangerous, since it can lead to the disruption of the eye mobility. Conclusion. During recurrent operations for strabismus correction it is recommended to use major recessions of the «strong» muscles, and for ease of muscle fixation at a great distance from the attachment point - the technique of the «sliding noose».

Keywords

strabismus / recession / resection / palisade nerve endings / technique of the «sliding noose»

References

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[2] Konaci K.Z., Streicher J., Hoetzenecker W. et al. Palisade endings in extraocular muscles of the monkey are immunoreactive for choline acethyltransferase and vesicular acethylcholine transporter // IOVS. - 2005. - Vol. 46. - P. 4548-4554.

[3] Wright K.W. Strabismus surgery. - Strategies and Techniques, 2000. - P. 138-145.

RIGHTS & PERMISSIONS

Zhukova O.V., Yamschikov N.V., Stepanov V.K.