Prismatic correction of residual or recurrent strabismus

Abstract

Introduction. Recurrent strabismus is a common issue after operations because of heterotrophy. Many scientific works have examined clinical parameters that may predispose to relapse of esotropia after surgery, including poor sensory status, high ratio of accommodative convergence to accommodation, uncorrected farsightedness or combination of these factors. Purpose. To evaluate the effectiveness of prismatic correction of recurrent esotropia in patients after the first stage of surgical treatment. Material and methods. The study group included 24 patients. They were divided into two groups in depends on the postoperative functional treatment. 1st group consisted of 12 patients with partially accommodative esotropia aged 5 to 8 years (6,48 ± 1,12 years) with average hypermetropic refraction +3,10 ± 0,54 diopters. This group of patients was assigned prismatic correction after a relapse of esotropia. 2st group consisted of 12 patients with partially accommodative esotropia aged 5 to 8 years (6,22 ± 1,29 years) with average hypermetropic refraction +3,13 ± 0,61 diopters. This group of patients was assigned orthoptic treatment after a relapse of esotropia. Results. Prismatic correction contributed to recovery binocular vision at 75 % of patients with recurrent esotropia ≤ 20 PD, in the comparison group (orthoptic treatment) – at 50 %. Moreover, the number of patients with stereopsis in the group «EFP» after the treatment was higher than in the group «Synoptophore» (p < 0,05). Conclusion. Prismatic correction ensures optimal motor status while maintaining sufficient sensory balance in most patients with recurrent esotropia after performing recession rectus medialis in combination with median duplication m. rectus lateralis. Keywords: Recurrent strabismus, binocular vision, elastic Frensel prism