Risk Factors for the Surgical Failure in Different Types of Strabismus
Huseyin Gursoy, MD, Associate Professor; Ertugrul Colak, PhD, Associate Professor; Idil Cakmak
Eskisehir Osmangazi University Medical Faculty Hospital
Introduction: To analyze the effects of various independent factors on midterm surgical outcomes in different types of strabismus.
Methods: Strabismus cases, who underwent surgery from January 2015 to June 2016 were reviewed. Minimum follow-up was 12 months. Success was defined as alignment with 10âˆ† of orthophoria. Binary logistic regression with backward stepwise method was used to determine the significant factors associated with failure. Various independent factors (age at surgery, sex, best-corrected visual acuity, refraction, types of strabismus, surgical choice [unilateral vs bilateral], presence of oblique muscle dysfunction (OMD), restriction, nystagmus, neurologic disease, alphabet patterns, secondary surgery, amount of deviation) were included.
Results: 159 cases with a mean follow-up of 15.2 (12-24) months and a mean age of 18.4 (1-67) years at surgery were included. 66 esotropia (45 infantile, 18 sensory, 3 residual), 40 exotropia, 11 consecutive exotropia (CXT), 17 sensory exotropia, 18 vertical strabismus, 10 Duane retraction syndrome were analysed. OMD was present in 24 cases. Unilateral surgery was preferred in 67 patients. There were 24 failures (15%)). The diagnoses of exotropia (Odds ratio [OR] = 6.3, P = 0.001), and CXT (OR = 10.1, P = 0.008), performance of symmetrical surgery (OR = 3.7, P =0.039) and preoperative angle of deviation (OR = 1.043, P = 0.015) were associated with surgical failure.
Discussion: Multicenter studies with longer follow-up are needed to support our findings.
Conclusion: Exotropia, CXT, deviation amount, and symmetrical surgery was associated with poor surgical outcomes.
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2. Sawada M, Hikoya A, Negishi T, Hotta Y, Sato M. Characteristics and surgical outcomes of consecutive exotropia of different etiologies. Jpn J Ophthalmol. 2015;59:335-40.