Results of complex treatment of concomitant strabismus in children

Abstract

Introduction: Diseases of the oculomotor apparatus are one of the causes of disturbances in visual function in childhood. According to the generalized data, concomitant strabismus affects about 2- 3% of children. Treatment of strabismus in children is important to be done timely and durable. That determined the purpose of the study. The goal of the study is emphasizing the role of the complex treatment (pleoptic, surgical and ortopto-diploptic) ofstrabismus in children with functional and aesthetic purposes.

Materials and methods: For observations were taken in Ovisus Clinic 45 children with strabismus (26 girls and 19 boys). According to diagnosis were taken as evidence the following children: with convergent alternating strabismus -15,6%; monolateral for the right eye -33,3%, monolateral for left eye 37,8%; divergent alternating strabismus- 8,9%; monolateral for the right eye 2,2%; monolateral for left eye 2,2%. The angle of deviation present in the studied patients before surgery:11-20*-64,4 %; 21-35* -26,7 %;>36*-8,9%. Preoperative visual acuity in patients is as follows:0,9-1,0- 24,4%; 0,7-0,8- 37,8%; 0,5-0,6- 20%; 0,3-0,4-15,6 %; 0,1-0,2- 2,2%. The binocular vision was monocular for 51,1%, simultaneous vision 26,7%, binocular vision 22,2%. During preoperative period 29 (64,4%) patients received active pleoptic treatment. 16 patients (35,6%) were taken under surgery without pleoptic treatment. Surgical correction of strabismus was performed in all children. Age surgery is as follows: from 1.4 to 4 years - 6 children (13,3%) of 4-7 years - 20 children (44,5%) of 7 to 10 years - 15 children (33,3%) aged over 10 years - 4 children (8,9%). Ortopto-diploptic postoperative treatment was performed in 39 patients (86,7%).

Results: In the postoperative period was reached ortoforie for 28 patients (62,2%), 3 * -5 * residual angle was kept for 13 patients (28,9%) in the remaining 4 cases (8,9 %) residual vertical deviation is observed. For the second stage of surgery were taken 11 patients (24,4%). Visual acuity of patients was increased by: 0,1-0,2-33,35%; 0,3-0,4- 40%; remained the same (0.9-1.0)- 24,4%; remained (0.1-0.2) – 2,25%. The binocular vision became monocular for 15,6 %, simultaneous vision 22,2%, binocular vision 62,2%. According to the degree of fusion of 28 patients (62,2%) who carried out the exercises at sinaptofor were achieved good results: 0*- 33,3%; +1+4*-13,3%; +5+9*- 8,9%; >10*- 2,2 %; indefinite - 4,5 %.

Conclusion: Surgical treatment is not unique to squint in children, but only one step in the complex treatment. Result of the treatment is based on pre- and post-surgery methods.