Hernández SLR, Castro PPD, Ruban RE, Pons CL, Lora DK, Dorrego OM

Language: Spanish
References: 26
Page: 227-235
PDF size: 152.23 Kb.

ABSTRACT

Objective: to find out the surgical outcomes achieved in adult patients aged over 18 years, who were operated on from more than 50 D deviation angle exotropia.
Methods: a retrospective and descriptive study was conducted from September 2009 through September 2010 in nine patients, who had gone to the pediatric ophthalmology and strabismus service of "Ramon Pando Ferrer" Cuban Institute of Ophthalmology. They all underwent a single-stage three horizontal muscles squint surgery.
Results: the largest group was made up of male patients aged 18 to 28 years for 80%; none of both sexes was significantly predominant. The preoperative deviation was similar near and distant, with mean deviation of 80 D. Of the five overcorrected patients one month after surgery, all reached orthotropia a year later, except for one female patient who showed overcorrection from the very beginning and is waiting for another surgery to correct the residual angle of 25 D.
Conclusions: after this surgery, great improvement of the psychosocial and functional subscales was attained, which leads to remarkable rise of the quality of life in these patients. Almost all of them reached ocular alignment in just a single surgical time, and one year after surgery, all except one were found orthotropic.

REFERENCES

1. Schuller J, Ellis FJ. Unique Features of Adult Strabismus. American Orthoptic Journal. 2008;58(1):21-6.

2. Scott WE, Kutschke PJ, Lee WR. 20th Annual Frank Costenbader Lecture-Adult Strabismus. J Pediatr Ophthalmol Strabismus. 1995;32(6):348-52.

3. Surgical Therapy for Treatment of Adult Strabismus 2009. Disponible en http://www.medscape.org/viewprogram/18822

4. Kraft SP. The Functional Benefits of Adult Strabismus Treatment. American Orthoptic Journal. 2008;58(1):2-9.

5. Hatt SR, Leske DA, Bradley EA, Cole SR, Holmes JM. Development of a quality of life questionnaire for adults with strabismus. Ophthalmology. 2009;116(1):139-44.

6. Jackson S, Harrad RA, Morris M, Rumsey N. The psychosocial benefits of corrective surgery for adults with strabismus. Br J Ophthalmol. 2006;90(7):883-8.

7. Leske DA, Hatt SR, Holmes JM. Test-Retest Reliability of Health-Related Quality of Life Questionnaires in Adults with Strabismus. Am J Ophthalmol. 2010;149(4):672-6.

8. Durnian JM, Owen ME, Marsh IB. The psychosocial aspects of strabismus: correlation between the AS-20 and DAS59 quality-of-life questionnaires. J AAPOS. 2009;13(5):477-80.

9. Black BC. Value-Based Medicine and Adult Strabismus Treatment. American Orthoptic Journal. 2008;58(1):10-3.

10. Hatt SR, Leske DA, Kirgis PA, Bradley EA, Holmes JM. The effects of strabismus on quality of life in adults. Am J Ophthalmol. 2007; 144(5):643-7.

11. Van de Graaf ES, Felius J, Van Kempen-du SH, Looman CWN, Passchier J, Kelderman H. Construct validation of the amblyopia and strabismus questionnaire (A&SQ) by factor analysis. Graefes Arch Clin Exp Ophthalmol. 2009;247(9):1263-8.

12. Holmes JM, Strauber S, Quinn GE, Cole SR, Felius J, Kulp M, et al. Further validation of the amblyopia treatment index parental questionnaire. J AAPOS. 2008;12(6):581-4.

13. Hatt SR, Leske DA, Bradley EA, Cole S, Holmes J. Comparison of quality-of-life instruments in adults with strabismus. Am J Ophthalmol. 2009;148(4):558-62.

14. Hatt SR, Leske DA, Adams WE, Kirgis PA, Bradley EA, Holmes JM. Quality of life in intermittent exotropia: child and parent concerns. Arch Ophthalmol. 2008;126(11):1525-9.

15. Hatt SR, Leske DA, Bradley EA, Cole S, Holmes J. Development and initial validation of quality-of-life questionnaires for intermittent exotropia. Ophthalmology. 2010;117(1):163-8

16. Bez Y, Coþkun E, Erol K, Cingu AK, Eren Z, Topçuoðlu V, et al. Adult strabismus and social phobia: a case-controlled study. J AAPOS. 2009;13(3):249-52.

17. Coats DK, Paysee EA, Towler AJ, Dipboye RL. Impact of large angle strabismus on ability to obtain employment. Ophthalmology. 2000;107(2):402-5.

18. Thomas S, Guha S. Large-Angle Strabismus: Can a Single Surgical Procedure Achieve a Successful Outcome. Strabismus. 2010; 18(4):129-36.

19. Lau FH, Fan DS, Yip WW, Yu CB, Lam DS. Surgical outcome of single-staged three horizontal muscles squint surgery for extra-large angle exotropía. Eye. 2010;24(7):1171-6.

20. Currie ZI, Shipman T, Burke JP. Surgical correction of large-angle exotropia in adults. Eye. 2003;17(3):334-9.

21. AmitavaAK, GoswamiAK, Mishra A. Large-angle strabismus and primary true muscle transplantation. J Pediatr Ophthalmol Strabismus. 2005;42(4):211-5.

22. Schwartz RL, Calhoun JH. Surgery of large angle exotropia. J Pediatric Ophthalmol Strabismus. 1980;17(6):359-63.

23. Berland JE, Wilson ME, Saunders RA. Results of large (89 mm) bilateral lateral rectus muscle recessions for exotropia. Binocul Vis Strabismus Q. 1998;13(2):97-104.

24. Millán T, Monteiro de Carvalho K, Minguini N. Results of Monocular Surgery Under Peribulbar Anesthesia for Large-Angle Horizontal Strabismus. Clinics (Sao Paulo). 2009;64(4):303-8.

25. American Academy of Ophthalmology. Pediatr Ophthalmology and Strabismus. USA: American A of Ophthalmology. 2011. (Basic and clinical Science course)

26. Stoller SH, Simon JW, Lininger LL. Bilateral rectus recession for exotropia: a survival analysis. J Pediatr Ophthalmol Strabismus. 1994;31(2):89-92.