METHOD FOR SURGICAL MANAGEMENT OF REPEATEDLY OPERATED STRABISMUS WITH HYPERACTIVE EFFECT Russian patent published in 2019 - IPC A61F9/07 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, specifically to ophthalmology. For surgical treatment of repeatedly operated strabismus with hypereffect during operation, a recessive muscle is extracted, sutured with a needle thread so that each needle is sutured transversely to a half of the muscle at its attachment point, at distance of 1–2 mm from it, thorough hemostasis is carried out, then the stitched muscle is cut off from the attachment point and its reduction is performed by fixing the two-sutured muscle to the sclera in the projection of the anatomical attachment point, wherein the same needles are made in the scleral thickness parallel to each other, after the needle sticking, a single knot is first knotted, and then the knot joint, on the second opposite muscle, 2–4 mm recession is made, the conjunctiva are sutured in the projection of both muscles so that knot-knot on each muscle is exposed. On the next postoperative day, if the eye is in the correct position, the knotted knot is transformed into a single knot, a double knot is added and sutures are applied on the conjunctiva. In the case of hypereffect, the knotted rib on the repositioned muscle is dissolved, and the single knot is moved to a length depending on the postoperative squint angle, the knotted knot is tied, the patient is asked to look towards the repositioned muscle, wherein the single unit moves to the sclera to the required length, then one additional and one double nodes are additionally applied. In case of insufficient effect after this manipulation, knot-rib is untied on recessed muscle, muscle is moved by two ends of thread closer to place of its initial attachment by length, depending on angle of residual strabismus, single unit is moved to sclera and knot is added, said actions are repeated until achieving the required result, wherein the knot-rib is transformed into a single knot, on which a double knot and seams are applied on the conjunctiva. In case of hypoeffect, knot-bow is unfolded, single unit is moved 2 mm above sclera, knot-knot is again fastened, patient is asked to look towards recessive muscle, wherein the unit moves to the sclera at the required length, the above actions are repeated until achieving the required result, wherein the knot-rib is transformed into a single knot, on which a double knot and seams are applied on the conjunctiva.

EFFECT: method improves accuracy of correction of repeatedly operated squint by means of action, including, and on opposite from the operated muscle for balance achievement, and also improves cosmetic effect due to elimination of effect of "pulling" of an eyeball into an orbit.

1 cl, 1 dwg, 3 ex