Heavy complications of the survey operation. Squint after surgery surgery and squint the correction of view what to do after the surgery

Or squint - the defect of the anxious system, in which the deviation of one or both eyes is observed when looking straight. Such pathology may occur both in children and in adulthood. Treatment must be integrated.

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Strabism and its consequences

The squint requires immediate therapy. With its absence, ambulopia develops, two-fed violation of vision and bias in the eyes. In addition to health problems, a number of complexes are formed in a patient who will prevent his normal life.

The reasons

There are a large number of causes of seproinability. Congenital pathology arises on the background:

• anomalous development of the embryo;
• premature births;
• genetic factor;
• congenital cataracts.

Acquired deviation occurs under the influence of a number of negative factors and concomitant diseases. The main reasons for the development of stabysma:

• oncology retina eye;
• belmo;
• paralysis of the eye muscles;
• high pressure;
• brain injury;
• diabetes;
• thyroid disease;
• atrophy of the optic nerve;
• encephalitis;
• astigmatism;
• cataract.

It is often observed in patients with severe psychological state.

Symptoms

Symptoms directly depend on the type of pathology. The squint can be paralytic and friendly. In the first case, stabism arises against the background of paralysis of one of the muscles of the eye. As a result, one eyeball deviates from the axis.

The patient stops perceiving the image with two eyes. Frequent headaches and dizziness are observed. A person cannot determine the location of a particular subject.

In the case of friendly strabismus, both eyes can move in all directions. At the same time there is no bone in the eyes. When you try to focus on the subject both eyes deviate aside.

The squint may be accompanied by myopia, farewell, astigmatism and other violations of the visual system. In some cases, lifebide can not manifest itself.

Classification

Two mains stand out: friendly and paralytic. First view often occurs in patients with AMETROPY and anisometropy. With a paralytic type of deviation, there is a binocular vision and violation of binocular vision. This type of pathology may arise as a result of injury, toxicosis or strong poisoning.

There are also the following form of strabismus:

1. Converging. The eye is directed to the nose. It often occurs against the background of depreciation.
2. Dravel. Fits with myopia, with the eye directed to the temple. The cause can be a disease of the brain, fright or infectious damage.
3. Vertical. The eyeball can mow up or down.

Atypical forms are very rare. They are due to anatomical anomalies in development. For example, Down syndrome or Brown.

By stability, the squint may be permanent or constant.

Diagnostics

Only an ophthalmologist can put the accurate diagnosis. For this, a visual inspection is carried out and causes of the disease. The survey implies an audit of visual acuity, determining the angle of strabismus and evaluating the friendly eye with the help of special mirrors. The doctor studies the mobility of organs of vision in different directions.

To confirm the diagnosis requires a neurologist consultation. Sturdy's treatment begins from the date of diagnosis and it can last from 2 to 3 years. In some cases, it is impossible to completely get rid of the defect, but only to improve the patient's condition.

Treatment methods

The methods of therapy of the squint can be divided into traditional and surgical interference. Under traditional treatment, a number of techniques aimed at the normalization of the muscle glasses and an increase in visual acuity are implied.

Opinion expert

Slonimsky Mikhail Germanovich

Ophthalmologist of the highest qualification category. It has tremendous experience of diagnosing and treating diseases of the eyes of adults and children. More than 20 years of experience.

Therapeutic treatment implies occlusion and hardware impact. The first option is to wear special stickers and occluders, which contribute to the integration of both eyes into the visual process. The wearing mode of such products is determined by the doctor, after a careful examination of the patient.

Hardware therapy normalizes visual functions using a targeted comprehensive stimulation. This uses modern high-tech appliances.

Surgical treatment is prescribed with ineffectiveness traditional methods Therapy. The operation allows you to restore a symmetrical or close to the symmetry of the eye by normalizing the muscular balance.

As an additional technique or prevention, the gymnastics of the eye is carried out. The exercise complex is picking up the doctor. Most often it is a variety of exercises with a lace, pictures or flashlight.

Surgical therapy is based on weakening or enhancing the muscles that are responsible for movement. eyeball. With a strong area, several operational interventions may be required at once.

Operational intervention is carried out in outpatient conditions. The need of hospitalization depends on the state of the patient and the recommendations of the surgeon. Most people return to normal life a few days after surgery.

Indications

For adults, the operation is carried out at any age for children - starting from 6 years. In some cases, the doctor may decide on the need for surgical treatment Sturboism at an earlier age.

The testimony includes a violation of binocular vision and the ineffectiveness of conservative therapy.

In what cases can you refuse?

A specialist may refuse to conduct operational intervention. This is possible if the patient has a disease in an exacerbated form. Contraindications include the presence of infectious resorts of the respiratory tract: a runny nose, cough and other symptoms.

Types of surgical intervention

With seproinacy, several types of operational intervention can be carried out. Depending on the testimony, it is carried out:

• bearing of the o'clock muscle to tendon or scler;
• mescitomy - cutting muscles, without superimposing seam;
• resection of parts of the muscle - removal of the extra part of the muscular fiber;
• minting the muscle folds.

The essence of intervention is reduced to the fact that too long muscle is shortened, and short - lengthens.

Preparation

The operation is carried out under anesthesia and in an outpatient basis. The patient must come on an empty stomach, at least 6 hours after the last meal. In the case of the morning operation, it is forbidden to drink and eat after midnight. If the procedure is planned for afternoon, a light breakfast is allowed, but no later than 8 am.

1-2 weeks before surgery, you need to go through the following surveys:

• hCV study;
• morphology with a smear;
• analysis of potassium level and sodium in the blood;
• blood coagulation time;
• analysis on sugar;
• analysis for the presence of the HBS antigen.

In the presence of concomitant diseases, additional research and consultations with other specialists are appointed. Patients over 40 years old need to pass an EKG study with a description, and after 60 years is assigned a RTG study chest with description.

Before the operation, it is recommended to make a vaccination from hepatitis B. Safe level of antibodies is observed on the second week after the introduction of the second dose of the drug. The third vaccination protects the body for a longer period - from 5 to 8 years. The effectiveness of vaccination is determined by analyzing the level of antibodies.

How is the procedure?

To carry out the operation, it is necessary to ensure complete immobility of the eye muscles. Adult intervention is carried out under local anesthesia, and children - under general anesthesia.

Stages of holding:

1. Outing a special mask on a face with eye slits.
2. Fixing the age of struts.
3. Get access to eye muscles through incision in the scler.
4. Correction of muscle length.
5. Overlay suture.

The probability of preservation of pathology after the operation is 10-15%. To save the result and avoid complications, it is necessary to restore correctly.

Recovery period

In the first few days after the operation, the operated eye may be, look blushing and sweeping. Temporary impaired view is also considered the norm. Because of the seams there is a feeling of an extraneous subject in the eye.

To avoid the development of complications, after the operation you need to observe gentle mode.

During the first weeks, anti-inflammatory drugs are required. TabradEx is most often appointed 3 times a day at 1 drop. Purulent discharges need to be removed by washing with warm boiled water.

The first control is carried out a week after the intervention. The doctor assesses the healing process and, if necessary, prescribe additional drugs. Further control is appointed for 2-3 months.

What you can not do

Within a month, it is impossible to float. It is necessary to protect the eyes from pollution. For 2-3 weeks you need to refuse physical Loads. If the correction of the squint was carried out in a child, he is issued exemption from physical education lessons for a period of six months.

Possible complications

Immediately after the correction, the patient can bother in the eyes. This is a normal phenomenon that takes place in itself in 2-3 days. In most cases, the remedial operation of the squint passes without complications. However, it is not always possible to get a 100% result after the first intervention. In some cases, several procedures are required.

To the number possible complications There is a reduction in vision, improper alignment of the axis of the eye or the occurrence of an unfavorable reaction to anesthesia. There is also a risk of infectious damage.

Useful video

Strabismus. How to return the "straight" look:

Cost

The cost of treatment depends on many factors. The price of the operation is indicated by one eye. On average, surgical intervention will cost about 27,500 rubles. Correction of paralytic squint will cost 82500 rubles.

Often, the surgery on the squint does not immediately return normal vision. Many agree that it is a pity to look at the jacket young cute girl or child. Without this cosmetic defect, everything would be fine. In addition, ophthalmologists recommend before falling under the knife, try conservative methods of treatment of the squint.

What is stubism, or squint

The squint is a pathology, in which one, both or alternately right and left eyes deviate from the normal position with a direct look. When a person looks at the object, the information obtained by each eye is slightly different, but the visual analyzer in the cortical department of the brain merges. With squinting, the pictures are very different, so the brain ignores the frame from a roofing eye. The long-term existence of the squint leads to amblyopia - a reversible functional reduction in view when one eye is almost (or completely) not involved in a visual process.

The squint may be congenital or acquired. Newborn often has a floating or junning look, especially after severe birth. Treatment with a neuropathologist can remove or facilitate manifestations of generic injury. Another reason may be an anomaly of development or improper attachment of the glasses (see Fig. 1).

Acquired squint arises as a result:

infectious disease: influenza, measles, scarletins, diphtheria, etc.; somatic diseases; injuries; sharp drop in view of one eye; myopia, hyperopia, astigmatism high and medium degree; stress or strong fright; pan or paralysis; diseases of the central nervous system.

How can you get rid of the squint

The squint corrects:

wearing special glasses; A number of eye exercises; Wearing a dressing closing one eye; Surgical Correction Surgery.

Non-permanent squint when sometimes mowers right or left eyes, try to adjust the dressings wearing. Quite often helps long-term use of specially designed glasses. Exercises for strengthening the ability to focus recommend almost all patients with stabism. If all of these methods have not corrected vision, the survey is carried out to adjust the strainship. This type of surgical intervention is carried out both in infancy and adult age.

Types of reclamation operations

Children and adults meet the following types of stubism:

horizontal - moving and consisting relative to the nose; vertical; Combination of two types.

With a converging squint, doctors face more often than with divergent. Together with converging strokes, the patient may have facilities. At myntic people usually observed diverging squint.

During operation can be carried out:

operating a reinforcing type; Operating a weakening view.

With a weakening operation, the eye muscles transplant a little further from the cornea, which deflects the eyeball in the opposite direction.

During the reinforcing operation, a small piece of the eye muscle is removed, which leads to its shortening. Then this muscle is sewn to the same place. The surgical intervention in the correction of the squint involves shortening and weakening the necessary muscles, which restores the balance of the eyeball. The operation is carried out on one or both eyes. The microsurgery determines the type of surgical intervention, when the patient in a fully relaxed state is on the operating table.

In some clinics, the operation is carried out under local anesthesia only adults. And in others - all patients make common anesthesia. Depending on the age, the state of health and other factors are carried out mask (laryngeal), endotracheal anesthesia Using muscle relaxants or an alternative view of anesthesia.

It is important that during surgical intervention The eyeball was fixed and there was no tone in the muscles, because the surgeon spends a special test: it estimates the degree of restriction of eye movements by moving it in different directions.

Adult man after surgery on the same day can go home. The child needs preliminary hospitalization. Most often with children in the hospital are the mother, the entry takes place the day after the operation. The recovery period takes about 14 days. After discharge, the patient extends sick leave or certificate in your clinic.

It should be noted that in 10-15% of cases, the squint is not eliminated until the end and the re-operation may be needed. Reduced the percentage of failure helps surgical intervention with the use of adjustable seams. After waking up the patient, the doctor after a while checks the condition of the eyes under local anesthesia. If there are deviations, it pulls the joints slightly slightly and only then they finally fixes them. All types of operations are performed fully resolved suture.

In adults who lived considerable time with the squint, sometimes after the operation two in the eyes, because the brain is canceling to perceive a binocular picture. If the doctor has established a high probability of the development of bias in the eyes, adjusting the squint is made in two stages so that the brain can gradually adapt.

Conducting an operation

A few days before surgical intervention, you need to pass blood tests, make an ECG and take advice from some specialists. 8 hours before the operation, it is impossible to eat. If it is appointed in the morning, you can dine, and if in the afternoon, then a light breakfast is allowed. A child with mother put in a hospital a couple of days before the operation. The procedure is carried out under general anesthesia. Operation itself lasts 30-40 minutes, then the patient is derived from anesthesia and translated into the ward. All this time on the eye is a bandage. After the patient operated on the patient completely moved away from the anesthesia, in the afternoon he examines the surgeon. He opens the bandage, checks the eye, bursts special drops and again closes it. Adults then release home with detailed recommendations: what drugs to receive than to bite the eye and when coming to repeat. The dressing on the eye is left until the morning of the next day. A week later, it is necessary to look at the inspection, where the doctor will appreciate the healing speed and the condition of the eye. The final assessment of the position of the eyes is carried out in 2-3 months.

A few weeks after the operation, special anti-inflammatory drops are used and (if necessary) antihistamines. The eye will turn red and sweep. Sometimes the next morning the eye sticks out due to the accumulated pus. No need to be frightened: it is washed with warm boiled water or sterile saline. A couple of days the eyes will be very watched and hurt, it will also seem that there are sorties in the eye. The seams are independently absorbed after 6 weeks.

Within a month after surgery, it is necessary to carefully guard your eyes. It is impossible to swim, be in dusty rooms and play sports. Children at school are free from physical education for half a year.

A month after surgery, you need to undergo a course of treatment. To return the binocular ability to see and recognize the correct picture, you need to go through special hardware treatment in the medical center. In some clinics there is an ambigor complex, developed by the specialists of the brain institute. Treatment on this device is a computer video study. It helps to overcome the skill of suppressing one eye. While watching a cartoon or cinema in a patient continuously remove the EEG of the visual cortex of the brain and readings about the eye of the eyes. If a person sees two eyes, the film continues, and if only one, suspended. Thus, the brain teach to perceive the picture with both eyes.

Source: Operational Intervention Types in Space

Types of operational intervention in space

The main task of any operational intervention in the squint should be considered the recreation of the right balance between the eye muscles responsible for the movement of the eyeball.

In the production of reinforcing operation, the eye muscle is shortened due to:

education of special folds in the place of tendon (tenorraphia); Move the muscle attachment location to the eyeball (Anteposition).

A weakening reclamation operation is aimed at removing excessive voltage and weakening the eye muscle due to:

changes to her place attachment to the eyeball (recession); its extension (plastic); the ineffectiveness of non-surgical treatment conducted for a long time; Very severe degree of squint; Non-formational sturdy.

Back to the category

Each of these periods has great importance to the favorable outcome of the operation.

Actually, the operation includes the conduct of high-tech manipulations of the competent surgeon-ophthalmologist to resolve the correct balance between the ill muscles of the patient in order to revive symmetry in the placement of the eyes. The operation is carried out using painkillers.

Postoperative recovery can be different time gaps from different patients. It lies in strict compliance with all the recommendations of the attending physician on liquidation:

eye discharge; doubles in the eyes, etc.

It is important to understand that to eliminate the squint, the operation must be carried out in a strictly defined time set by the doctor. It is impossible to postpone it, because The view of the vision can significantly decrease. It is impossible to forcing events, which will not affect the result. In some cases, surgery consists of several necessary steps.

After the elimination of the strabismum is surgically, various complications are possible, to eliminate which additional eye treatment is required or re-operation. The main complications of this kind must be considered:

excessive correction;

A source:

Strabismus

The ultimate goal when conducting operations on the area of \u200b\u200bspace is the restoration of the symmetric (or as close as close to the symmetric) position of the eyes. Such operations, depending on the situation, can be carried out both in adulthood and in children.

Types of operations to correct the squint

In general, the surgery is two types. The first type of operations is aimed at weakening overly intense ooo muscle. An example of such operations is the recession (the intersection of the muscles at the place of attachment and move it in such a way as to weaken its action), partial myotomy (partial excision of a piece of muscle fibers), muscle plastic (for the purpose of elongation). The second type of operations is aimed at enhancing the action of a weakened glasses. An example of second-type operations is resection (excision of a section of weakened muscle next to the attachment point with subsequent fixation of the shortened muscle), tenorraphia (muscle shortening by forming folds in the muscular tendon area), antietpsion (moving the place of fixing the muscles in order to enhance its action).

Often, during a recharge operation, a combination of the above-mentioned types of operational intervention is applied (recession + resection). If, after performing surgery, there is a residual squint, which is not leveled by self-correction, it may be necessary to re-operation, which is usually performed after 6 to 8 months.

For achievement maximum efficiency When carrying out an operation to correct the squint, it is necessary to adhere to several basic principles.

1. Excessive forcing the process of surgical correction of the squint often leads to unsatisfactory results. Therefore, all manipulations should be dosed (if necessary - in several stages).

2. If you need to attenuate or enhance individual muscles, dosage surgical intervention should be uniformly distributed.

3. During the execution of the operation on a specific muscle, it is necessary to maintain its connection with the eyeball.

High-tech Surgery Space:

Cellists of children's eye clinics have developed modern high-tech radio wave surgery with the principles of mathematical modeling.

Advantages of high-tech eye surgery:

1. Operations are small, thanks to the use of radio waves, the structures of the eye are preserved.
2. After operations there are no terrible edema, the patient is discharged from the hospital the next day.
3. Operations are accurate.
4. Thanks to the principles of mathematical calculation, we can provide the highest accuracy and show the guaranteed result of the operation before it is carried out.
5. The rehabilitation period is reduced by 5-6 times.
6. General provisions when conducting surgery

• reinforcing;
• weakening.
• excision of some of its plot (resection);
• excision of part of muscle fibers (partial myotomy).
• paralytic squint;
• preoperative preparation;
• actually surgery;
• postoperative recovery.
• redness of the eyes;
• discomfort and pain with sharp movements, with bright lighting;
• various inflammatory processes in operated places.
• reducing the angle of strabismus in front of pleoptic or orthoptic treatment,
• preventing the development of contracture of the outdoor eye muscles with a large amount of squint,
• for the purpose of functional cure from the squint,
• with a cosmetic goal, if it is impossible to improve vision or teach proper binocular vision.
• Weakening. In the course of such an operational intervention, the place to which the muscle is attached is transplanted for a longer distance from the cornea. Due to this weakens the impact of that muscular fabricwhich deflects the eye from the center of the axis.
• Reinforcing. Such an acuplication operation is removed due to the excision (shortening) of the muscle, and the place of its location remains the same.
• the age of the patient;
• features of the arrangement of muscle fibers;
• angle of squint;
• general condition and features of the movement of the eye, etc.
• if the doctor decided that the correction should be phased, do not insist on the opposite and rushing the events;
• fully adhere to all destinations after the operation, which gives medical personnel;
• for adult patients, it is advisable to carry out simultaneously weakening and reinforcing measures.

Nowadays, the survey has become one of the most popular methods to combat this ailment. For this type of violation, vision is characteristic when one, or both eyes in turn deviated when looking forward. If the eyes are arranged symmetrically, the image of the subject of the subject falls exactly to the center of each eye. Due to this, the picture is combined, and we see the volumetric items.

When the eyes look not at one point, the image begins to double, and the brain has to filter information transmitted by the roofing eye. If it does not take measures on time, ambulopia can develop, almost complete functional loss of vision of the eye, which is not involved in building visual images.

Why adult people have squint

Sturdyby, as the physician disease is called, in adulthood can be a residual manifestation of problems with the vision, which have arisen as a child, but also acquired. Often, doctors cannot accurately establish, which served as a reason for the development of the disease. It can be both acquired and congenital features of the body:

• such violations of violations as far-sightedness, myopia, astigmatism;
• injuries obtained;
• paralysis;
• disorders in the development and structure of muscles, moving eyes;
• violations in the work of the CNS;
• rapid impairment of vision, affecting only one eye;
• consequences of stress or mental injury;
• previously transferred to Cort, Diphteria or Scarlantine.

What is the squint

The squint can be acquired, congenital. Also distinguish constant and non-permanent squint, which manifests itself periodically or disappears at all over time. Two species of this disease are distinguished.

When both eyes deviate in turn

With friendly sturdy, as you can guess from the name, both eyes are submitted. They alternately coit about the same range. The main cause of this pathology of vision is an ametropium.

Main distinctive features:

• if a person looks at a fixed thing, then one eye slightly deviates to the nose, or to the temple;
• at the same time, the deviating eye may vary;
• the mobility of the eyeball is stored in all directions;
• a person does not observe the doubles of the picture before the eyes;
• lack of a patient in binocular vision;
• the primary and secondary angle of deviation of the eye of a kosying eye is almost the same;
• there may be a deterioration in sight of the oblique eye.

As a rule, a person with friendly squint is observed other violations of vision: myopia or hyperopia, astigmatism.

When only one eye mows

The second type of pathology is paralytic squint. The main difference between this type of violation of vision - the junning eye does not move, or moves limitedly towards the affected muscle. The image begins two, and the person loses the ability to see in volume. Felling of nerves, improper functioning of eye muscles, tumors and injuries.

The signs of this type of pathology include:

• where the muscle is amazed, the eye does not move;
• primary and secondary deviation angle differ: secondary more;
• two image, loss of surrounding;
• dizziness;
• forced easy deviation of the head toward the sick eye.

Paralyotic squint is subject to all age categories: it can develop at any age.

Other types of squint

In addition to the above, there are discouraged and divergent (exotropy) squint, as well as vertical. In the first case, the junning eye deviates towards the nose. County squint in children is diagnosed more often than in adults, in the process of maturation it often disappears completely. As a rule, pathology develops against the background of depreciation.

Drawing squint in adults is characterized by the fact that the eye deviates towards the temple. Pathology arises in innate or acquired myopia. With a vertical one, one eye is directed up or down relatively healthy.

Cultural treatment

Is it possible to fix the squint? The answer is yes. Sturdyby can be heal. For this, special prismatic glasses are used, or resort to operating intervention. In the course of the development of the disease, good vision is preserved only at the eye that transmits the image of the brain. An unfinished eye starts to see everything worse, since the brain suppresses its visual functions to achieve a stable and clear image. Therefore, it is extremely important to promptly begin treatment of strabismus in adults, as soon as the first signs of the disease are noticed.

To achieve the result, both separate ways and procedures and procedures can be applied:

• use for eye vision correction, contact lenses;
• treatment of amblyopia hardware methods;
• activities aimed at restoring binocular vision;
• surgical intervention.

Operational intervention

Operation with stabysme is carried out in aesthetic purposes to restore the symmetrical location of the eyes. But the operational intervention itself without comprehensive treatment Will not restore vision. The surgeon decides on the method of eliminating the problem directly during operational intervention. It is possible to determine what way to carry out the operation is only taking into account the location of the eye muscles of a particular patient. In some cases, both eyes operate at once. The main goal of the operation is to lead to the right position and the tone of the muscle deviating eye.

After surgical correction disappears the need to wear uncomfortable prismatic glasses. This is one of the main reasons why the ophthalmologist sends the patient to the surgeon. Correction Operation Acrossisement allows you to improve the quality of life, to remove the constraint due to the negative perception of the squint, restore the good emotional state. The cost of the operation in each case is calculated individually.

Is the operation dangerous

The surgical experience of the eye always implies certain risks. When eliminating the squint by the operational method, the negative consequence occurring more often is a two-way image. It usually passes after a while, but there are cases when the bone remains. More serious risks include: reducing the quality of vision, retinal detachment, infection and problems caused by anesthesia. Fortunately, all these complications are extremely rare.

An important factor is the overall health. The better the patient's well-being, the simpler operation will pass, and the eye will be restored faster. In any case, do not worry. The modern level of development of medicine, high-quality equipment and professionalism of doctors make the likelihood of developing events in a negative key striving for zero.

What results it is possible to achieve with the operation

Most patients are diagnosed with a significant improvement in view after surgery. It happens that the full correction of the strainship does not occur immediately, and the body requires a long time to restore after a successfully completed operation. In some cases, a re-operation may be required. The residual boss arising after surgical manipulations is usually eliminated by prismatic glasses.

Patient recovery after surgery: Do you need to dispensarization

The first days after the operation, the patient can feel discomfort and headaches, pain at the tension of the eye muscles, the feeling of the presence of an extraneous subject in the eye. In this case, the doctor prescribes to him painkillers. After a few days, unpleasant symptoms go, and the patient can return to active life. However, heavy loads are better to avoid within a few weeks.

Whether hospitalization will be required after surgery. Depends on the general state of the patient and the recommendations of its attending physician. Most of the operations passes in the outpatient mode, and the operated patient returns to normal life after a couple of days.

The postoperative recovery goes, on average, about a week. However, in addition to rehabilitation, a course of hardware treatment may also be required to achieve a maximum result and tangible increase in the quality of vision. Vision will be recovered for a longer period. Help in this charging for eyes and therapeutic procedures.

The survey operation is available for patients of any age. How much is the operation, you can find out by posting your personal advice on an ophthalmologist. Average prices - from 15,000 rubles to 30,000 rubles for one eye. This is a great way to reduce the symptoms, adjust the aesthetic consequences of the squint and simply improve the quality of life. Surgical treatment of strabismus today is considered effective and safe way Restoration of vision. Correct the squint without dispensarization and subsequent long-term recovery.

The squint can be congenital in nature, as well as arise as a result of the impact of various factors. And at least some consider strabismus only an aesthetic problem, in fact, this pathology can provoke the formation of many unpleasant consequences. For the patient, it is very important not only to diagnose the disease in a timely manner, but also to get to solve this problem as early as possible. Speclacy surgery - radical and effective method.

Squint and its consequences

The squint is diagnosed in the presence of existing deviations in the parallelism of the visual axis of the eye. More often the patient mows only one eye. In some cases, the deviation is symmetrically. There are several types of squinting and methods to solve the problem, too, several: wearing special glasses, shutting down one eye body, operation.

IMPORTANT: Most specialists tend to ensure that surgery is carried out in extreme cases. To begin with, it is recommended to try the conservative correction methods of the squint.

What threatens the squint? Full loss of vision of the eye body, which has deviations. In this case, the brain ceases to receive volumetric pictures, and the images do not correspond to each other. The nervous system gradually blocks the data taken from the defective eye organ. The muscular tone is started. The functioning of the eye over time is very worsening and ambulopia develops in 50% of cases.

Causes of Formation of Sturdy

The squint may be acquired or congenital. The formation of each of them has its causes of occurrence. For instance.

Acquired view of Sturbize

Most often, this type of squint develops in children until the six months achieve. A significant role in this case is the existing diseases that provoked such by-effect. But the episodes of the development of stabysma and in the older age-old category are not uncommon. The most frequent causes of the development of the Acquired Space:

• sturdybide as a result of sharply deteriorated vision during astigmatism, hyperopia, as well as myopia;
• disorders of the refraction of the eye can provoke a developing cataract or glaucoma, and as a result, the squint is formed;
• paralysis of the eye muscles are able to cause psychological disorders, as well as somatic diseases (as an example: neurosophilis, encephalitis);
• easy degree of squint can provoke disorders in blood circulation and sharp pressure jumps, and when ignoring pathology - disability;
• proclaiming seproinishing factors, specialists also consider such children's diseases like Scarlatina and Kor.

Important: In the case when the child had a predisposition to squint, pathology is able to manifest itself as a complication after transferred diphtheria or influenza.

Sturdyby is able to develop in children preschool age After a strong frightened, as well as the result of the suffered psychological injury. These reasons for the development of pathology were recorded from senior patients. Although in more rare cases.

Congenital view of Sturbizma

In practice, congenital squint is very rare. More rarely, it can be found in its pure form, that is, immediately at the birth of the baby. The manifestation of pathology in the first six months of the life of the kid is established as infantile. More often in the newborn there is imaginary squint. The kids of this age are unable to accurately focus, and at the same time it seems that the child is formed by pathology.

Interesting: imaginary squint can be observed in adults when a person is in a state of intoxication.

Infantile squint is often formed in genetic disorders and at that time when the fruit is still in the womb. This can be caused by such diseases: cerebral palsy, Cruzone or Down syndrome, as well as hereditary predisposition. In cases with heredity, one of the kid relatives also have similar deviations.

In the risk group there are kids, whose mothers have suffered during pregnancy infectious diseasesapplied drugs, as well as medications without appointing specialists.

Operation with squinting is the only solution to the problem?

The resolution operation of the squint refers to the radical methods of solving the problem. Immediately after the diagnosis, the specialist will offer conservative treatments that relate to more gentle ways. It can be special glasses. Their task is to make both eye organs focus on one point. Over time, the muscles of the damaged eyes are being developed. Pathology is gradually corrected.

If the patient mows one body, the "Disconnecting Eye Organ" procedure may be proposed. For these purposes, a special bandage is placed on a healthy eye. Thus, the brain begins to receive the image only from the patient. Muscles are gradually developing and pathology is corrected.

The operation is recommended in more trusted cases. She can not guarantee full recovery Lost view, but allows you to achieve a more symmetrical relationship between the eye bodies. More often, young people agree to the operation, for whom it is very important to externally do not have defects.

Testimony

1. The patient used all conservative methods of treatment, but no improvements were achieved (or they were not achieved in the maximum volume).
2. The patient wishes to eliminate cosmetic defects in the shortest possible time. Conservative treatment can continue for several months, or even years.
3. The patient has strong defects. The doctor considered it expedient to initially restore vision with the help of surgical intervention, and only then apply conservative methods for fixing or improving the result obtained earlier.

Important: The operation may be contraindicated only in cases where the patient has individual characteristicswho are pre-negotiated with their specialist.

There are some age restrictions. For example, the optimal age for surgical intervention is considered to be 4-5 years old by a child. Younger patients may refuse. An exception is the congenital form of a squint, which is corrected in 2-3 years. This is simply explained. After the operation, the patient must adhere to a special mode and perform special exercises. For up to 4 years old, they will not be able to do it consciously and independently. The chances of the fact that pathology will come back.

Principles and types of surgical intervention in the elimination of the squint

Surgical reclamation interference is carried out by several types of operations. Sometimes a specialist picks up one optimal option for this situation, but more often during operation, several types are combined with each other. Read more about each form.

1. The muscle recession involves cutting off the tissues from its physiological attachment. After cutting down the muscle is fed. The specialist picks up an optimal place for its future fastening. It may be a tendon, as well as a sclera. According to the result, fiber shifts back and its action is weakening. In the event of a fiber displacement, the effect of muscles is intensified.
2. Operation MEETTOMICA implies similar manipulations with cutting muscle. The difference from the previous species is the lack of procedures for overlapping seams.
3. Smaller injury to the eye body can be achieved using Faden operation. In this case, manipulations with cutting muscles are not made. The fabric immediately shakes to the scler. With this procedure, non-restering threads are used.
4. In case the muscle is weakened and it is required to increase its action, a shortening operation is used. During the surgical intervention, part of the muscle is removed.
5. It will also help a similar effect of the operation. It implies the creation of folds between tendon and muscle. A variant is possible when this fold is formed inside the body of the muscle itself.

Any of the selected correction operations of the squint is carried out in compliance with the main principles. Correction must be phased. The operation is carried out only on one eye body. On the second procedure repeated after a few months (approximately 3-6). Although with a small corner of the cat, the surgeon can be made to make a correction at the same time on two eyes, but this is more often an exception.

Features of the operation

If a patient has a strong squint, the operational intervention is performed in several receptions. The fact is that it is undesirable to carry out more than two muscles at a time.

The elongation or shortening of the muscle must be evenly carried out from all sides. For example, if the muscle on the right is reduced in size, then it should be reduced to the left. At the same time, the size of the excision and increasing is necessarily identical.

Observing all the main principles of surgery, the specialist is trying to maximize the connection of the eyeball and the operated muscle.

For adult patients, correction is carried out under local anesthesia. Upon completion, the patient is superimposed by the patient. You can go home after a few hours. For children (any age), general anesthesia is always applied. In mandatory, the child is hospitalized for a day, but cases and with a longer stay in the hospital are not excluded.

Those who have the opportunity to correct pathology in foreign clinics is worth paying attention to German and Israeli specialists. Their approach to such correction is more radical. Almost all types of pathologies are corrected into one reception. Another plus is the possibility of carrying out the kids to a year.

Rehabilitation period

Though the correction operation is carried out in one day and the patient is immediately released home, this does not mean that there is no rehabilitation period. To quickly restore the binocular vision, you need to adhere to certain recommendations of the doctor for some time and perform special eye exercises.

The first day after surgery the eye body will be hurting, lightly flies and inflaces. This is a natural state. Also possible short-term impairment. During this period, each of its movement needs to be monitored, as any touch touch attempts can end only with reinforcing pain syndrome.

Important: Restoration of the fabrics of the eye organ and binocular vision comes a month later. Most patients all this time see a twofal picture. If, after this period, the vision is not restored, you need to contact an ophthalmologist.

In children, adaptation time is significantly reduced. The main thing is to fulfill the exercise prescribed by a specialist and visit an ophthalmologist.

For active recovery, a specialist can recommend to take advantage of special correction glasses, and from time to time to cover a healthy eye. This will help create a load on the operated organ. Muscles are faster and acquired the necessary norm.

What complications should be expected after surgery

The most frequent complication that is found in medical practice after a surveillance operation is hypercorrection. It is formed with an excessive elongation or sewing of the muscles of the eye organ. The main reasons for such an undesirable effect:

• surgeon error;
• incorrect preliminary calculations;
• natural patient growth, which affects the increase in the eye body in size.

IN lately Specialists have found an optimal way to minimize the risk of such a complication. Increasingly, operations are carried out with non-cut, but inserting muscle folds. In this case, the superimposed seam is regulated and correcting the undesirable effect can be a minimally invasive way.

The formation of a coarse scar at the place of cut-off of the muscle and the subsequent sewing. Such a method of surgical intervention deprives the tissue of muscle mobility and elasticity, which are partially replaced by fibrous. The only alternative is at the moment is to reduce the size of the excised area.

The squint is returned through time (recurrence). This complication most often arises due to the fault of the patient himself, who neglects the observance of all rules in postoperative period. Children recurrence may occur due to sharp increases in the load on the eye body. For example, a correctional surgery was carried out at the age of five or six years, and after a couple of months later, the child began to attend school.

The most serious, but very rare complication is damage during the operation of a wandering nerve that is responsible for the work of lungs, gastrointestinal organs and heart muscles.

Heavy complications of surgical treatment of squint:

Element infection
- Endophthalmita
- Postoperative necrotic scarce
- "Extralling" muscles
- "Loss" (retraction) muscles
- Retinal disinsertion
- Sunshine syndrome
- Front Cut Ischemistry

but) Ischemia of the front segment after surgery about the area. Each straight muscle is bloodshed in two front cylinder arteries (branches of the eye artery), with the exception of the outermost muscle, which receives blood supply only from one artery: in the oblique muscles of the ciliary arteries does not pass.

The frequency of pronounced ischemia of the front segment is probably 1: 13,000 cases. This complication was not included in the BOSU study, since often the anterior of anterior segment remains not detected, especially in children who have a study on the slit lamp after the operation is usually not performed. Heavy outcomes are rarely noted, although the upatrophy of the eyeball is described. The risk factors of the anterior segment include the age of previously transferred interventions on direct muscles, operations on several muscles (especially direct) of one eye, circulation disorders (for example hypertension or diabetes), identical interventions on neighboring direct muscles, operations on vertical direct muscles and Lembal cuts.

In children, simultaneous interference in more than two direct muscles can be safe, but most surgeons avoid operating immediately on four straight muscles. If you need to operate more than two straight muscles in an adult patient, or the patient has high risk The development of anterior segment ischemia, it is possible to carry out interference with the preservation of the anterior ciliary arteries by dissection of the front cylinder arteries from the muscle or the execution of partial transposition of the tendon while maintaining at least one of the front cylinder arteries.

The clinical picture of the anterior segment ischemia can vary from light uveitis and height of iris to keratopathy.

The front segment of 1 degree ischemia is detected only with iriography of iris.

The anterior segment of 2 degree ischemia is caused by the hypiperphous of the iris sites and sometimes manifests the anomalies of the pupil shape. Treatment is rarely required.

The anterior segment 3 and 4 degree ischemia usually requires treatment with local or systemic corticosteroids. Non-standard treatments are used, including hyperbaric oxygenation. The overwhelming majority of patients are recovered with minor consequences, such as iris atrophy, coroptopia, or attenuation of pupil reactions.

Front segment ischemia:
(A) Heavy ischemia caused the edema of the cornea.
(B) the same eye six months later; Pay attention to the moderate expansion of the pupil.
(C) Front closet of lens due to ischemia of the front segment.
(D) Rainbing atrophy due to the anterior segment.

b) Perforation of the eyeball when surgery about the squint. The perforation of the eyeball is most frequent of the heavy complications of the surgical treatment of the squint, its frequency is reported to be from 0.13% to 1% of cases. In the BOSU study, its frequency was 1: 1000. This complication more often met in children, but as noted above, the difference did not reach statistical significance. It is possible that the frequency of this complication depends on operational access. In one case, the outcome was extremely unfavorable. The patient has developed endophthalmite, he was made by evisceration.

Although the perforation of the eyeball is often found, unfavorable or extremely unfavorable outcome is extremely rare. Complex interventions, such as FADEN operation, can more often complicate perforation of the eyeball.

In the BOSU study, cases of perforation of the eyeball when applying traction seams are noted. In some cases, the perforation was accompanied by opening the anterior chamber and the hypotension of the eyeball, which greatly made it difficult to intervene. In most cases, intraoperative treatment was performed by intraoperative treatment, usually cryotherapy or laser adoption. Announced one case of retinal detachment in a patient with high myopia, which during the Harada-ITO operations on both eyes was perforation of both eyeballs.

Methods for the treatment of perforation of the eyeball are not substantiated in accordance with the standards of evidence-based medicine. In 90% of cases, cryotherapy and / or laser budigulation are used. In children, the perforation of the eyeball happens more often, but the retinal detachment is unlikely, since at this age vitreous body decorated. To confirm the diagnosis, we perform intraoperative ophthalmoscopy, expanding the pupil by introducing 1 or 2 ml of the local anesthetic under the tenon capsule. Alone, we do not treat the complication of intraoperative, but attract a vitreoretinal surgeon to consult a vitreoretinal surgeon if possible. In adults, we perform ophthalmoscopy and, if the patient has a high risk of retinal detachment (i.e. high myopia), we are intraoperatively carrying out the holes, and then attract a vitreoretinal surgeon.

We do not conduct treatment in patients with low risk of retinal detachment, but send them to the consultation of a specialist in vitreoretinal pathology. All patients receive antibiotics systemically in order to reduce the risk of endophthalmita. In the BOSU study, one case of endophthalmita has a three-year-old patient who demanded evisceration. Rathod reports two cases of endophthalmita, two retinal detachments, one suprahrioidal hemorrhage and one choroidal scar.

Prevention of perforation of the eyeball includes:
1. Avoid the imposition of seams in the fields of the schondrification of the sclera.
2. Methods (i.e., the imposition of suspended seams), which do not require the imposition of gluable seams directly in the locations of the sclera or hard-to-reach zones.

Complications of perforation of the eyeball.
(A) Chorioretinal scar after perforation of the eyeball during the intervention about the squint.
(B) Formation of a filtration cushion after unnoticed perforation sclera lymbapian traction seam three years ago.
(C) Scleromation four years after the intervention about the squint at the site of the initial attachment of the muscle.

in) Element infection after a survey operation. The infection of the eye after operational interventions about the squint almost the same often flows in two forms: diffuse cellulite of the society and abscess at the point of attaching the muscle. In the study of BOSU, 13 cases were noted, of which only two in adults. In three cases, the abscess at the point of attaching the muscles was accompanied by the "slipping" of the muscles that demanded a surgical audit. Kothari described the same complication on both eyes of one patient. The treatment is determined by the prevalence of infection in the eye: with diffuse damage, systemic antibiotic therapy is carried out. The abscess of attaching the muscle, if it is accompanied by the "slipping" of the muscle, requires surgical audit, drainage and systemic use of antibiotics.

In the case of endophthalmita, with histological examination, it was revealed that the infection penetrated the eyeball through the abscess of the muscle attachment site, which indicates the need for a more aggressive approach to the treatment of postoperative infection of the muscle attachment site. There were no such cases in the BOSU study.

d) Postoperative necrotizing sclerit. Postoperative necrotizing sclertis (Surgally Induced Necrotizing Scleritis, Sins) is a rare, but severe complication of surgical treatment of the squint. The literature describes only one case of this complication in children, but in the BOSU study, six cases of SINS in adults developed within 1-6 weeks after surgery, usually manifesting pains in the eye. Tresed by local and systemic non-steroidal anti-inflammatory drugs or steroids. One difficult case required the use of cyclophosphamide and led to the development of the rear synechs, cataracts and a decrease in vision to 0.6 logmar (6/24, 20/80, 0.25). In 50% of cases, an unfavorable or extremely unfavorable outcome was noted. Most patients were elderly; Two were from 20 to 30 years.

The figure below shows the case of a postoperative necrotizing sclerite, which was cured with oral and local non-steroidal preparations without any consequences. Perhaps, given a bad prognosis according to BOSU research, patients with postoperative necrotizing glorite should advise a specialist in inflammatory diseases.

Light glorites can often occur after surgery about squinting, manifest with pain, more pronounced and deeply localized than usual, and diffuse inflammation of the sclera, and require the reception of oral unnecessary anti-inflammatory drugs. Risk factors include age, circulation disorders, application of diathermocoagulation sclera and ischemia.

Localized abscess.
(A) Local subconjunctive abscess.
(B) When pressed from abscess, a pm may be released.
(A) This 16-year-old patient after the recession of the inner straight muscle on the adjustable seams about the fracture of the lower wall of the orders with a stupid injury of the eye developed postoperative necrotic scarce.
The conjunctive covering the sclerite zone is held by the seam.
(B) Appearance after treatment with local steroids and oral nesteroid drugs.

e) "Loss" (retraction) muscles. In the BOSU study, the cases of intraoperative "loss" muscles were taken into account. Six cases of "losses" of muscles, five of them are registered - in adult patients, most of - In the elderly patients, in four cases the patient had previously suffered an operational intervention about the squint. In four cases, the inner straight muscle was "lost", in two - outdoor straight. Most often, during the operation, the loss of inner direct muscle is loss. This may be due to the frequency of performing operational interventions on various muscles or with anatomical features. Other straight muscles have sprouts with oblique muscles, which prevent the retraction of the muscles in the eyeboard.

In all patients in the Bosu study, during the operation, it was possible to find muscle: only one outcome was unfavorable or extremely unfavorable.

If, during the operation, the muscles' retraction occurred in the eyelet, it is best to find it right away. A common mistake is muscle search near the eyeball, since straight muscles lie at some distance from it. Ask help from an experienced surgeon, use suitable retractors to provide a review and follow the hemostasis. With careful inspection, it is usually possible to find a tendon case containing the muscle. Some authors for finding the muscles are offered to use Okulocardial Reflex: when filming the muscles, the heart rate will decrease, but this method is applicable only in part.

If you cannot find the muscle, enter the hanging ligaments surrounding the muscle and the tongs of the capsule to the original place attachment of the muscle: to some extent the pulling power of the muscle can be transmitted to the eyeball through these fabrics. Perhaps the transposition of the muscle; However, adults should be alertness in the forefish ischemia. Perhaps, upon subsequent revision, a more experienced surgeon will be able to find the muscle. Postoperative examination includes MRI and CT, especially with muscle loss due to injury or in innate or acquired anneal anomalies. If the muscle is localized in the rear sections of the orbit, orbital access is possible.

e) "Extralling" muscle. In the study of BOSU, hypercorrection and reducing the volume of movements in the direction of the operation of the operated muscle of more than 50% were considered manifestations of "slipping". 18 cases have been marked, this complication has met a little more often in children. In three of them, the "slipping" muscles were caused by infection at the place of its attachment. In three cases, an unfavorable or extremely unfavorable outcome was noted; All these patients were children.

There are two main forms of "slipping" muscles. The true eluding muscle is similar to the lost muscle: the failure of the seams or fixing the muscles shortly after the operation. In case of insolvency, the muscle seams is slipping. This complication is treated in the same way as a lost muscle. More often, slipping muscles is developing for several weeks or years after surgery and is accompanied by a pronounced limitation of the escaped muscle.

In revisions, it is often found that the muscle is fixed to the scler not directly, but by means of a long pseudo-sumility, which is a stretched scarsing tissue. These changes can develop with time due to the stretching of poor-quality fixed muscles. In this case, pseudo-suming is removed and re-fix the muscle to the eyeball. At the same time, the shortening of the antagonist muscle may require the fulfillment of its recession and the recession of conjunctiva.

g) Safety syndrome after surgery. It is a restrictive state, often progressive, caused by the falling out of the fatty fiber of the society through the incision of the back of the tonon capsule during surgery about the squint, usually during interventions on the lower oblique muscle. Sometimes sleeping syndrome complicates injury or intervention on centuries. To prevent this complication, the rear edge is visualized by the rear edge of the lower muscle and capture the crochet only with the muscle; Sometimes excessive bleeding worsens visualization and contributes to the scarring. Upon prolapse of the fatty fiber of the socket during operation, the fiber is excised and restore the integrity of the tonon fascia. Often, this complication is revealed after the operation, when the patient develops progressive hypertropy and element limit.

Surgical treatment is a revision of the lower vessel, excision of the pumping fluid fiber and closing the defect of the rear ventilation capsule, after which the recession of the lower straight muscle, the tonon capsule and conjunctivations with the amnion flask are performed.

h) Endophthalmita. During the biennial period, the Bosu study registered one case of endophthalmita, thus its frequency was 1: 24,000 cases. The diagnosis and treatment of endophthalmite is described in individual articles on the site - please use the search form on the main page of the site.

The patient with the "escaped" inner direct muscle of the right.
(A) Pay attention to the pronounced exode formation and hypofunction of the innermost muscle.
(B) When re-operation revealed: the muscular hook is started under the pseudo-eyed inner straight muscle at 11 mm from the limb.
Pinzet is imposed on the proximal end of the inner straight muscle. Pay attention to the difference in the color of muscle tissue and pseudo-sumil.
The 14-year-old boy performed the standard myctomy of the lower oblique muscle of the right eye about the paralysis of the fourth nerve on the right. 271 10/22/2019 5 min.

Correction Correction Operation (Sturdy) is a radical and effective method of eliminating this defect. This manipulation is recommended in running cases. In less severe situations, stabism is trying to correct with the help of gentle methods. Surgical intervention does not guarantee full recovery of the lost vision, but allows you to achieve a more symmetrical relationship between vision bodies. There are several ways of surgery. The choice of concrete depends on the severity and type of violation.

Testimony for surgical intervention

The most favorable age for surgical intervention aimed at vision correction in children is 4-6 years old, but, in the case of congenital pathology, it can be carried out earlier - in 2-3 years. During the period from 4 to 6 years, it is best to determine the angle of the squint. Somewhat more difficult.

Operation to correct the squint, or stabysma, prescribe both adults and children.

Indications to carry out surgical intervention with stabysme are:

• the lack of results, that is, achieve the symmetric position of both eyes, after a conservative treatment;
• squint, provoked by eye injury;
• the desire to adjust the cosmetic defect that occurs in the squint;
• twist in the eyes, which is especially characteristic of older children, as well as adults, first faced with the pathology of the eyeballs;
• pronounced paralytic squint;
• the defeat of the two organs of vision at once.

Read more about the treatment of paralytic squint.

Not always to correct all the intervention is enough for the correction, in some cases a whole series of operations is required.

Preparation for the operation

Proper preparation has no less value than the operation itself. It includes the normalization of both the physical and psychological state of the patient (which is especially important for children). First of all, a patient is examined to identify existing deviations. Also before the planned operation, it is necessary to carry out measures for the sanitation of LOR-organs and the oral cavity. The best exercises from the squint are collected by software.

Ophthalmological preparation is the most important stage of the preoperative period. Depending on the form of an area, such activities are required:

• elimination;
• training of eye muscles;
• treatment on synopoform;
• coordinimetric study.
• Also before surgical intervention, an ECG is prescribed.

Preparation for the operation can do from 3 to 6 months.

Varieties of surgical methods

All varieties are divided into two main groups:

• manipulations aimed at weakening muscles;
• operations that enhance muscle action.

To the first group of operational interventions, which are conducted with rationalism include:

• recession of the ooo muscle. The essence of the operation is to remove the tissue at the place of its attachment, after which the muscle merges with scler and tendon. As a result of such manipulations, fiber moves back and its action is weakened;
• partial myotomy. Such a method provides for cutting off the muscle, but without further applying seams.

The course of reclamation surgery.

Another way to conduct surgical intervention is the muffling of the muscle immediately to the scler with non-reprehensive threads.

If only one eye kosses, the operation is carried out on it. If there is a violation at once on both bodies of sight, then intervention is performed on each of them.

Even if a child or an adult has a significant angle of squint, it is not recommended to act simultaneously more than two muscles. In case, after interference, the angle under stabysme remains pronounced, re-treatment is carried out, but not earlier than 6-8 months. The main causes of the squint are described in.

Usually, when performing an operation on the eyes in the presence of an angle of mowing, all 6 o'clock muscles, holding the eyes in a natural position, are affected.

Principles of intervention

To achieve the best results from surgical therapy, it is necessary to adhere to the following key principles:

In foreign clinics, the problem is tuned to a more radical solution: in medical institutions in Germany and Israel, vision is corrected immediately, in one operation, even if the squint applies to both eyes. Also in these countries, children are operative interference under the age of year.

Course of operation

8 hours before the start of the operation, it is impossible to eat. If it is appointed in the morning, then in the evening you can easily dine. Interference is carried out under general anesthesia. In general, it lasts 30-40 minutes.

In general, the correction is done in this way:

• after anesthetic begins to act, the eyelids will be removed using special devices - strut;
• on the face impose a sterile oilcloth with a slot for the eyes;
• the specialist produces a section of sclera and conjunctivities, opening access to the muscles;
• the eye is periodically wetted and constantly held in the correct position;
• the muscle is pulled out through the cut;
• fabrics are cut or shed, after which the seams are applied.

After completing the procedure on the eye, impose a bandage that is removed the next day.

If the deviation angle in children under the age of 5 years is more than 45 degrees, then the operation is carried out in 2-3 stages. First reduce the angle of the squint.

Hospitalization is usually not required and the patient can return home on the same day. Is it possible to the treatment of strabismus in adults at home is described.

There is another way of correction of stabysma. This is more modern methodwhich is high-tech - high-tech surgery. In this case, the squint is corrected by means of mathematical modeling and radio wave surgery.

Postoperative period

After the operation for the correction of stabysma, an adult or child requires a recovery period. It takes about a month, while children flows easier and faster. During this time, you must adhere to the following recommendations:

After correction, the following complications may arise:

• repeated development of stabysma. This is possible if the patient does not comply with the recommendation given by the doctor in the postoperative period;
• the formation of scarns that make eye mobility difficult;
• damage to the wandering nerve. This is very dangerous complicationSince he is responsible for the work of the heart muscle, the lungs, the organs of the gastrointestinal tract.

Video

This video will tell you about how the rechargement is being done.

conclusions

1. Operation on the correction of stabysma is appointed adults and children aged 4 years.
2. in complex situations The operation is carried out in several stages. It is not recommended to touch on more than 2 glasses. Operations are carried out at, and other types of squint.
3. before conducting surgical intervention, the patient's preparation for the event is required. This is especially true for children.
4. duration - about half an hour. The recovery period lasts about a month.
5. to avoid complications after surgery, it is necessary to comply with all the recommendations given by the doctor.

- The pathology of the oath muscle in which the eyeball is shifted from its normal location. As a result, a cosmetic defect is formed, a decrease in the visual acuity of the affected organ.

Indications for the operation

Most often, the squint is discovered in early childhood. In this case, the operation is not carried out immediately. First, any doctor will advise to take advantage of the conservative ways of treatment. But there are cases when it is not necessary to do without surgery:

• strong angle of deviation of the eyeball from the normal location in the eye;
• lack of effectiveness from a conservative method of treatment;
• lack of desire in a patient to carry out long-term conservative treatment, the need to obtain the effect immediately;
• high risk of ambulopia development - a sharp decline The functions of the view of one eye, as a result of which it turns off completely.

Before conducting the procedure, it is necessary to obtain permission from the attending physician.

Depending on the species of the pathology of the glasses, 2 types of operations are distinguished:

• reinforcing - tension and strengthening muscle tissue, due to which it will be able to hold the eyeball;
• weakening is to reduce the tension of the glasses, due to which the eye is strongly rejected to the temple area.

With a reinforcing operation, the eye muscles are cut and stretched, then sewed back. If, on the contrary, the muscle is strongly tense, it dissect in a certain place so that it stretches less.

The procedures are divided depending on the methodology for surgery:

• recession - noise of the oxular muscle and further sewing to the scler, resulting in a normal tension;
• miomectomy - disqualled muscle tissue in a certain place to reduce tension without subsequent stitching;
• recreation - the surgeon fully exchesies part of the muscle, stitching two extremes.

The choice of surgical intervention depends on the diagnosis of the patient.

In order for the ophthalmologist to put an accurate diagnosis, gave permission to the operation, it is recommended to carry out the following ophthalmic studies:

• evaluation of visual acuity using diagnostic tables;
• Ultrasound eyeballs;
• evaluation of the angle of deviation of the affected eye from a normal location.

Before conducting operational intervention, the patient must be passed the following tests:

• generalized blood and urine test, blood biochemistry;
• by the need for a coagulogram;
• hIV analysis and hepatitis C;
• fluorography;
• electrocardiogram.

Additionally, it is necessary to undergo a survey and get permission from the doctors of narrow specialties: a neurologist, cardiologist, a otolaryngologist, a dentist. If all analyzes are normal, an ophthalmologist can give permission to conduct an operation.

Also before the operation, the patient must comply with a number of rules:

• for a week it is impossible to use new medicinal productsthat the doctor was not warned;
• you can not drink alcohol in two days before the operation;
• before the procedure you need to take a shower, carefully wash your face and hair.

Special preparation for organs of vision is not required. It should be arrived at the clinical institution during the doctor appointed. If any of these rules are broken, it may lead to consequences, complications during or after surgery.

Operational intervention is carried out in several stages:

1. the patient falls on the couch, a disposable happy is worn on the hair;
2. make a common or local anesthesia, the last option is possible to apply only adult people;
3. with the help of a scalpel get access to the glasses;
4. if the muscle is not tensioned enough, it dissect and sew in the desired position;
5. if the muscles are stretched overly strongly, they are waiting, but do not sew;
6. closing of fabrics, applying antibacterial and anti-inflammatory agents.

A variant of the operation is possible without the Overaction Overall muscle. In this case, it is stretched and sewn in the desired position. The healing of fabrics in this case is faster.

Rehabilitation and recovery

After the operation is completed, the rehabilitation period begins. If the procedure was performed for an adult, he is kept in a clinical institution for several hours, then they are released home in the absence of complications. Children must be in the hospital 1-2 days. At home, you must perform the following actions:

• the use of drugs that prescribed a doctor (antibacterial, anti-inflammatory, moisturizing drops);
• in the first day after the operation, long holidays and sleep;
• wearing sunglasses in the open space under the action of bright sunlight;
• ban on visiting the baths, saunas, bathing in hot water;
• a ban on any physical activity before receiving a permit for her by a doctor;
• replacing contact lenses with glasses to prevent the risk of damage to the eye fabrics;
• re-visits to an ophthalmologist at the appointed time.

If all the stages of rehabilitation were completed, the risk of complications decreases.

Complications

During the operation or within a few days after it, the following complications may be the formation:

• hemorrhage in the cornea or inside the eyeball;
• breaking muscle tissue, damage in this area;
• a sharp decrease in visual acuity up to the full blindness of the affected eye;
• enhancing a bacterial infection into the inner tissues, the risk of sepsis (infectious infection of blood, which leads to the death of the patient without emergency medical assistance);
• inflammation of the age, cornea, conjunctiva;
• lack of an operation effect with further development of the squint.