Visual outcome and factors influencing surgical outcome of horizontal strabismus surgery in a teaching hospital in Malaysia: a 5-year experience

Abstract

Background: The available data on strabismus surgery in South East Asian countries is scarce. This study aimed to identify visual outcome and factors influencing surgical outcome of horizontal strabismus surgery in a South East Asian cohort. Methods: A retrospective review of patients who underwent horizontal strabismus surgery between 2013 and 2017 in Hospital Universiti Sains Malaysia was conducted. Surgery was considered successful if the post-operative deviation was within 10 prism dioptres at six months post-operative period. Factors influencing outcome of surgery at six months were identified. Chi-square and Fisher exact test were used in data analysis. Results: 98 patients were included. Both genders were equally affected. Exotropia (58.2%) was the most common type. 65.3% of patients had alternating strabismus, while 51.0% had angle of deviation more than 45 prism diopters. Amblyopia was documented in 14.3% of patients. Those operated upon below 10 years of age comprised 64.3%. Ninety four patients completed follow-ups at six months after the surgery. The success rate was 81.6%. Approximately 92% of the patients had best corrected visual acuities of 6/12 and better at six months post-operative period. There was no significant association between age of onset, gender, presence of amblyopia, type of deviation, amount of deviation and post-operative best corrected visual acuity with surgical outcome at six months post-operative period (p>0.05). Conclusions: The success rate was good. Post-operative best corrected visual acuity was promising. Age of onset, gender, presence of amblyopia, type of deviation, amount of deviation and post-operative best corrected visual acuity did not influence the outcome of horizontal strabismus surgery in our review. Keywords: Visual outcome, horizontal strabismus surgery, factors influencing surgical outcome

Evaluation of Factors Affecting the Outcomes of Strabismus Surgery and Treatment of Amblyopia

“…There is no consensus on which factors affect the outcome of the surgery most, both motor and functional. Therefore, due to many factors, surgery for the treatment of strabismus and the factors affecting it affect the results of strabismus surgery 16 .…”

Gambaran Kualitas Hidup Pasien Strabismus Menggunakan Kuesioner Adult Strabismus 20 Di Rumah Sakit Umum Pusat Sanglah Periode Januari 2019 - Desember 2020

“…Deviasi setelah operasi 5-10 PD untuk esotropia dan 10-15 PD untuk eksotropia. 6 Besar deviasi dapat dinilai saat sebelum dan setelah operasi melalui pemeriksaan Krimsky. Pada penelitian ini didapatkan mayoritas (80%) sampel memiliki deviasi pre-operasi lebih besar dari 20 PD.…”

“…4 Salah satu tatalaksana strabismus yang dilakukan adalah tindakan pembedahan, baik untuk mengembalikan posisi bola mata ke aksis visual normal sehingga dapat mengurangi diplopia, mendapat atau mengembalikan fungsi binokular dan mengembalikan bentuk anatomi normal. 5,6,7 Meskipun tindakan operasi strabismus pada pasien dewasa tidak memberi perbaikan fungsi binokular, namun dapat memperbaiki kepercayaan diri pasien sehingga dapat meningkatkan kualitas hidup pasien. 5 Pelaporan pasien yang menjalani operasi strabismus sebaiknya tidak hanya hasil motorik objektif, namun juga menilai dampak kualitas hidup sehingga bisa mendapatkan semua manfaat dari operasi.…”