rectus connective surgery

Under normal circumstances, the visual axes of the two eyes should be parallel when looking at the distant objects. The movements of the two eyes should be coordinated and balanced. The eye can be maintained by the fusion function of both eyes to maintain the gaze of the same target. When the eyeball position or motion abnormality causes the binocular visual axis to separate, it is called strabismus. The incidence of strabismus is 2.7 to 7.2% in foreign countries and 1-1 to 1.5% in domestic reports. Paralytic strabismus is one of the types of strabismus with extraocular muscles or abnormalities of their innervation. Children with paralytic strabismus are more likely to cause amblyopia, and often accompanied by abnormal head position, which is more harmful to children. Before the operation, it is necessary to find out the cause and then determine the surgical plan. Treatment of diseases: painful ophthalmoplegia paralytic strabismus Indication 1. Complete paralysis of any of the four rectus muscles, conservative treatment for more than half a year without any improvement. Generally, the horizontal extramuscular or internal rotation should not exceed the midline or the upper and lower rectus muscles should not go up or down. 2. When the rectus muscle is cut off due to trauma, the broken end cannot be found. 3. The iatrogenic previous surgery error, when the eye muscles are off the line and no muscles can be found. 4. Congenital absence of a rectus muscle. Contraindications 1. Antagonistic muscles of the palsy muscle should be free of severe contracture and fibrosis. If the traction test is positive, the first operation can resolve the contracted or fibrotic eye muscles, and then proceed to the next operation according to the situation. 2. Three straight muscles should not be cut in one operation, otherwise it may cause ischemia in the anterior segment of the eye. 3. After conservative treatment, the eye movement to the paralysis muscle side is improved or unstable, and treatment should continue. 4. The cause of the disease is not removed (such as cranial neuropathy). Surgical procedure 1. Make a large limbal conjunctival incision, and separate the conjunctiva, tenons sac, expose the entire attachment point of the external rectus muscle and the attachment points of the upper and lower rectus tendon. 2. Use the sputum hook to open the conjunctiva to expose the muscles. The lateral rectus, superior rectus, and inferior rectus muscles were splayed halfway along their length to the equator with a squint hook to the center of the attachment point, and were approximately 15 mm long. Use the 1-0 white silk thread to connect the upper half of the lateral rectus muscle with the outer half of the superior rectus muscle at the 10:30 and 7:30 amoral (right eye) of the equator of the eyeball, and the lower half of the lateral rectus muscle and the inferior rectus muscle. The outer halves are joined and ligated. 3. In operation, be careful not to ligature too tightly to prevent the blood circulation of the muscles. It is advisable to make the muscles just touch the ligature and not slip off. If the antagonistic muscle of the paralyzed muscle restricts the rotation of the paralyzed muscle (positive traction test), a small corneal conjunctival incision is made to migrate the inner rectus muscle (although surgery has been performed on the four rectus muscles, the anterior drug The blood supply is still sufficient, and the anterior iliac artery of the muscle on one side without surgery is still intact). Sudden conjunctival suture reduction.