Experience in the application of dosage anterior transposition of the inferior oblique muscle according to Kenneth W. Wright in case of vertical strabismus in children

    Abstract

    Experience in the application of dosage anterior transposition of the inferior oblique muscle according to Kenneth W. Wright in case of vertical strabismus in children

    V.V. Sorokina, A.E. Gorkin, N.A. Popova

    The Сlinic «Scandinavia», St.-Petersburg

    Purpose. To increase a treatment efficiency of vertical strabismus caused by the hyperfunction of the inferior oblique muscle and to evaluate results of the surgery of dosage anterior transposition of the inferior oblique muscle (IOM) according to Kenneth W. Wright technique.

    Material and methods. The hyperfunction of the inferior oblique muscle of various severity was diagnosed in 88 children. The process was unilateral in 28 cases, bilateral – in 60 children (120 eyes). The operation of the dosed anterior transposition of the inferior oblique muscle was performed in 148 eyes. The idea of the operation of the dosage anterior transposition of the inferior oblique muscle according to the Kenneth W. Wright technique was to transfer the natural place of attachment of the inferior oblique muscle from the posterior pole of the eye to its anterior segment, which allows to convert this muscle from the lifting muscle to the lowering one. The location of the new fixation point of the inferior oblique muscle determined its degree of weakening and it was a basis of the dosage for the surgical intervention.

    Results. As a result of surgery, the vertical deviation of the eyes in the primary position of the gaze was completely eliminated in 93% of cases, the «V»-syndrome – in 82% of children. The selective position of the head was terminated in 95.7% of patients with ocular torticollis. According to the indications, the next stage of surgical treatment was carried out. The binocular vision was achieved in 98% of cases.

    Conclusion. The operation of anterior transposition of the inferior oblique muscle according to Kenneth W. Wright technique is an effective method of correction for vertical strabismus.

    Key words. Vertical strabismus, non-concomitant strabismus, «V»-syndrome, ocular torticollis, anterior transposition of the inferior oblique muscle by Kenneth W. Wright.