Outcomes of ophtalmologic surgical procedures of esotropia in children and adolescents

  • Kljakovic-Avramovic T
  • Vukosavljevic M
  • Avramovic S
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Abstract

Background/Aim. Esotropia is the most common manifestation form of strabism accompanied by refraction deviations and amblyopia. The aim of this prospective study was to present the outcomes of surgical treatment of esotropia in children and adolescents. Methods. Within the period from January 1st 2006 to February 1st 2007 at the Clinic for Ophtalmology, Military Medical Academy, Belgrade a total of 25 patients with esotropia (34 eyes) and previously corrected refraction anomaly and treated amblyopia were operated on. The patients were 4-19-year of age. All of the patients were submitted to a complete ophtalmologic and orthoptic examination prior to the surgery, and a month, three months and six months after the surgery. The surgery was performed under general anesthesia. Out of the total number of the patients nine were operated on both eyes, while 16 patients on one eye with amblyopia or frequent esodeviation. Nine patients were submitted to retroposition of the inner straight muscle, two to myectomy of the outer straight muscle, while in 14 of the patients a combination of retroposition and myectomy was performed. The patients were divided into three groups according to the preoperative angle at the distance and followed-up accordingly after the surgery. Deviation angle at the distance in the group I was 18-25 DP, in the group II 26-35 PD, while in the group III it was 36-60 PD. Results. The most numerous, group I (12 patients; 48%), a month following the surgery showed angle reduction by 55.58%, after three months 63.25%, and after six months 63.92%. The group II consisted of 8 patients (32%) showed angle reduction by 70.75% a month following the surgery, by 76% after three months, and by 79.12% after six months. The group III (5 patients; 20%) showed angle reduction by 72.20% a month following the surgery, 79.20 after three months, and 80.12% after six months following the surgery. Conclusion. The best postoperative outcomes after a month, three and six months were obtained in the group of patients with the highest esodeviation angle at the distance solved by the surgery on both eyes. Timely surgical treatment befell into major precondition for developing and maintaining the elements of binocular vision in the operated on patients. .Uvod/Cilj. Ezotropija je najcesci manifestni oblik strabizma koji cesto prate anomalije refrakcije i ambliopija. Cilj rada bio je da se prikazu rezultati hirurskog lecenja ezotropija kod dece i omladine. Metode. U periodu od 01.01.2006. do 01.02.2007. u Klinici za ocne bolesti Vojnomedicinske akademije operisano je 25 bolesnika sa ezotropijom (34 oka) sa prethodno korigovanom refrakcionom anomalijom i tretmanom ambliopije. Bolesnici su bili starosti od 4 do 19 godina. Svima je uradjen kompletan oftalmoloski i ortopticki pregled pre, kao i jedan, tri i sest meseci nakon operacije. Svi bolesnici operisani su u opstoj anesteziji. Od ukupnog broja bolesnika devet je imalo operativni zahvat na oba oka, a 16 bolesnika na jednom oku, koje je bilo ambliopno ili je cesce pokazivalo ezodevijaciju. Kod devet bolesnika uradjena je retropozicija unutrasnjeg pravog misica, kod dva bolesnika miektomija spoljasnjeg pravog misica, a kombinacija retropozicije i miektomije kod 14 bolesnika. Prema velicini preoperativnog ugla na daljinu bolesnici su bili podeljeni u tri grupe i tako praceni i postoperativno. Ugao devijacije na daljinu u grupi I bio je od 18 do 25 PD, u grupi II od 26 do 35 PD, a u grupi III od 36 do 60 PD. Rezultati. Najbrojnija grupa I od 12 bolesnika (48%) nakon mesec dana od operacije imala je smanjenje ugla od 55,58%, nakon tri meseca 63,25%, a nakon sest meseci 63,92%. Grupa II od osam bolesnika (32%) nakon mesec dana od operacije imala je smanjenje ugla od 70,75%, nakon tri meseca 76,00% i nakon sest meseci 79,12%. Grupa III od pet bolesnika (20%) nakon mesec dana od operacije imala je smanjenje ugla od 72,20%, nakon tri meseca 79,20% i nakon sest meseci 80,12%. Zakljucak. Postoperativno, najbolje rezultate nakon jednog, tri i sest meseci dobili smo u grupi bolesnika sa najvecim uglom ezodevijacije na daljinu, koji je resen operativnim zahvatom na oba oka. Pravovremeno hirursko lecenje, vazan je uslov za razvijanje i odrzavanje elemenata binokularnog vida operisanih bolesnika. .

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APA

Kljakovic-Avramovic, T., Vukosavljevic, M., & Avramovic, S. (2008). Outcomes of ophtalmologic surgical procedures of esotropia in children and adolescents. Vojnosanitetski Pregled, 65(8), 627–631. https://doi.org/10.2298/vsp0808627k

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