Surgical Dose-Response Relationship in Patients with Down Syndrome with Esotropia; A Comparative Study
Ceren Gurez, MD; Osman Bulut Ocak; Asli Inal; Ebru Demet Aygit; Selcen Celik; Zahid Huseyinhan; Ahmet Demirok; Birsen Gokyigit
University of Health Sciences Beyoglu Eye Research and Training Hospital
Introduction: To compare the effectiveness of bimedial rectus recession surgery on the patients with Down Syndrome and normal neurological developmental patients.
Methods: We evaluate retrospectively our patients with Down Syndrome (age range 2-17 years), who underwent bimedial rectus recession surgery for esotropia. Control group was selected from the age-matched patients with normal neurological development. We compared case and control groups in terms of preoperative and postoprative esodeviation angle at 1 year follow-up, the amount of recession and surgical success.
Results: A total of 21 patients with Down syndrome and 42 control subjects were included. The groups did not differ in either preoperative (Down syndrome 39.73±8.47 PD, control 37.91±7.65 PD ) and postoperative near deviation angle ( Down Syndrome group 5.45±11.45 PD, control group 2.36±7.13 PD ) or amount of surgery ( Down syndrome group 4.68±0.40 mm, control group 4.78±0.38 mm ). Surgical success was achieved in 15 patients with Down syndrome ( % 80.90 ), and in 35 of control patients ( %83.33 ) at 1 year follow-up.
Discussion: The presence of ET in Down’s syndrome cases with strabismus is between 18%-70%. Only studies in patients with Down syndrome demonstrated a high success rate with standard bimedial rectus surgery. In our study, it was determined that in Down syndrome cases with ET, bimedial rectus recession surgery in accordance with the standard table was successful.
Conclusion: Surgical success between esotropia patients who underwent bimedial rectus recession surgery with or without Down syndrome was similar.
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