Journal List > J Korean Ophthalmol Soc > v.58(4) > 1010745

Yi, Park, and Shin: Clinical Features of Patients over the Age of 60 Years Who Have Undergone Strabismus Surgery

Abstract

Purpose

In recent years, there has been an increase in the number of strabismus operations performed on patients aged 60 years and over. This study aims to establish the characteristics and outcomes of old age strabismus.

Methods

Patients aged 60 years and over who underwent strabismus surgery between January 2011 and December 2015 were included in this study. The purpose of surgery, type of strabismus, etiology, postoperative recurrence, prevalence of general and ocular complications, and postoperative diplopia rate were reviewed.

Results

Ninety-eight patients aged 60 years or older were identified, and 58.2% of patients had strabismus surgery to improve diplopia, while 41.8% chose surgery for cosmetic purposes. Esotropia was the most common type of strabismus found in 40.8% of the patients, and horizontal-vertical combined type was the second highest at 29.6%. The etiology of strabismus was similarly high in both the restrictive pattern (31.6%) and neuro-paralytic pattern (30.6%). The recurrence rate after strabismus surgery was 4.1%, and the reoperation rate was 3.1%. The remnant diplopia rate after surgery in patients with diplopia was 15.8%, and the diplopia occurring rate in patients who underwent surgery for cosmetic purposes was 4.9%. No severe ocular complications such as anterior segment syndrome or eyeball rupture occurred. Anesthesia related problems did not occur in any of the patients who underwent general anesthesia.

Conclusions

Strabismus in patients aged 60 years and over is an effective and safe way to improve diplopia and cosmetic status by restoring ocular alignment.

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Figure 1.
Age distribution of patients over 60 years with stra-bismus surgery.
jkos-58-443f1.tif
Figure 2.
Type of strabismus in patients over 60 years. The most common type is esotropia.
jkos-58-443f2.tif
Figure 3.
Etiology of strabismus in patients over 60 years. Restrictive pattern and neuroparalytic pattern hold a majority of etiology.
jkos-58-443f3.tif
Table 1.
Patient's purpose of strabismus surgery
Sex Number of patients
Cosmetic Diplopia
Male 15 36
Female 26 21
Total 41 57
Table 2.
Subtype of strabismus according to etiology
Etiology Subtype Number of patients (%)
Childhood Childhood onset strabismus 7 (7)
Restrictive Hyperthyroidism 27 (28)
Myopic Strabismus fixus 4 (4)
Neuro-paralytic 6th nerve palsy 19 (19)
4th nerve palsy 4 (4)
3rd nerve palsy 3 (3)
INO 3 (3)
Post sinus surgery nerve paralysis 1 (1)
Post-operative Scleral encircling 2 (2)
Scleral buckling 1 (1)
Vitrectomy 3 (3)
Sensory Sensory esotropia 11 (11)
Sensory exotropia 31 (32)
Esotropia Adult onset idiopathic esotropia 3 (3)
Exotropia Adult onset idiopathic exotropia 7 (7)
Total 98 (100)

INO = internuclear ophthalmoplegia.

Table 3.
Purpose of surgery according to etiology
Purpose of surgery Number of patients (%)
Childhood Restrictive Neuro-paralytic Post-operative Sensory Esotropia Exotropia
Cosmetic 7 (100) 4 (13) 7 (23) 1 (17) 14 (100) 2 (67) 6 (86)
Diplopia 0 (0) 27 (87) 23 (77) 5 (83) 0 (0) 1 (33) 1 (14)
Total 7 (100) 31 (100) 30 (100) 6 (100) 14 (100) 3 (100) 7 (100)

Values are presented as n (%).

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