Comprehensive analysis of strabismus reoperations: clinical insights and progression factors.
Humans
Reoperation
Female
Retrospective Studies
Strabismus
/ surgery
Male
Oculomotor Muscles
/ surgery
Ophthalmologic Surgical Procedures
/ methods
Child
Child, Preschool
Visual Acuity
/ physiology
Adult
Adolescent
Middle Aged
Vision, Binocular
/ physiology
Young Adult
Disease Progression
Follow-Up Studies
Aged
Logistic regression analysis
Reoperation
Strabismus
Surgery
Journal
BMC ophthalmology
ISSN: 1471-2415
Titre abrégé: BMC Ophthalmol
Pays: England
ID NLM: 100967802
Informations de publication
Date de publication:
11 Oct 2024
11 Oct 2024
Historique:
received:
22
01
2024
accepted:
03
10
2024
medline:
12
10
2024
pubmed:
12
10
2024
entrez:
11
10
2024
Statut:
epublish
Résumé
To compare and analyze clinical characteristics of patients undergoing two surgeries and multiple surgeries and explore relevant factors to lay the foundation for clinical prediction. A retrospective analysis was conducted on clinical data from all patients who underwent twice and multiple strabismus surgeries at Tianjin Eye Hospital between October 2012 and September 2021. Patients were divided into Group A (two surgeries) and Group B (more than two surgeries) based on the cumulative number of surgeries performed. Clinical details at the first recurrence, including sex, age, native place, overall medical history, onset time, visual acuity, affected muscle(s), etc., were documented. Non-parametric tests and chi-square tests were used to analyze clinical characteristics in each group. Binary and ordered logistic regression analysis assessed parameters associated with multiple reoperations. A linear mixed-term model observed factors impacting affected muscle(s) during surgery. Researchers examined clinical traits related to secondary strabismus variables. Among the 910 included patients, 840 required two surgeries (Group A) and 70 underwent more than two surgeries (Group B). Significant differences were found in age, onset time, interval time, and secondary factors. Regression analysis highlighted the significant impact of interval time on the reoperation rate, effectively predicting outcomes in patients with concomitant strabismus. Other ophthalmoplegia and secondary factors significantly influenced reoperation rates in patients with non-concomitant strabismus. Interval time, esotropia, and exotropia were linked to concomitant secondary strabismus patients, while the number of surgeries, DVD, esotropia, exotropia, and esotropia V-pattern were associated with non-concomitant secondary strabismus patients. In a longitudinal study, patients with multiple surgeries showed a correlation between the vertical deviation angle magnitude and the number of involved extraocular muscles. Regression analysis revealed that in patients with concomitant strabismus, interval time, exotropia, and esotropia influenced the total number of muscles during surgery. For patients with non-concomitant strabismus, interval time, secondary factors, and SOP impacted the total number of muscles during surgery. Interval time in patients with concomitant strabismus, as well as secondary and other ophthalmoplegia in non-concomitant strabismus, are the main factors for multiple reoperations.
Sections du résumé
BACKGROUND
BACKGROUND
To compare and analyze clinical characteristics of patients undergoing two surgeries and multiple surgeries and explore relevant factors to lay the foundation for clinical prediction.
METHODS
METHODS
A retrospective analysis was conducted on clinical data from all patients who underwent twice and multiple strabismus surgeries at Tianjin Eye Hospital between October 2012 and September 2021. Patients were divided into Group A (two surgeries) and Group B (more than two surgeries) based on the cumulative number of surgeries performed. Clinical details at the first recurrence, including sex, age, native place, overall medical history, onset time, visual acuity, affected muscle(s), etc., were documented. Non-parametric tests and chi-square tests were used to analyze clinical characteristics in each group. Binary and ordered logistic regression analysis assessed parameters associated with multiple reoperations. A linear mixed-term model observed factors impacting affected muscle(s) during surgery. Researchers examined clinical traits related to secondary strabismus variables.
RESULTS
RESULTS
Among the 910 included patients, 840 required two surgeries (Group A) and 70 underwent more than two surgeries (Group B). Significant differences were found in age, onset time, interval time, and secondary factors. Regression analysis highlighted the significant impact of interval time on the reoperation rate, effectively predicting outcomes in patients with concomitant strabismus. Other ophthalmoplegia and secondary factors significantly influenced reoperation rates in patients with non-concomitant strabismus. Interval time, esotropia, and exotropia were linked to concomitant secondary strabismus patients, while the number of surgeries, DVD, esotropia, exotropia, and esotropia V-pattern were associated with non-concomitant secondary strabismus patients. In a longitudinal study, patients with multiple surgeries showed a correlation between the vertical deviation angle magnitude and the number of involved extraocular muscles. Regression analysis revealed that in patients with concomitant strabismus, interval time, exotropia, and esotropia influenced the total number of muscles during surgery. For patients with non-concomitant strabismus, interval time, secondary factors, and SOP impacted the total number of muscles during surgery.
CONCLUSIONS
CONCLUSIONS
Interval time in patients with concomitant strabismus, as well as secondary and other ophthalmoplegia in non-concomitant strabismus, are the main factors for multiple reoperations.
Identifiants
pubmed: 39394059
doi: 10.1186/s12886-024-03712-2
pii: 10.1186/s12886-024-03712-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
446Subventions
Organisme : General Project of Tianjin Health Science and Technology Fund
ID : TJWJ2021MS041
Organisme : Tianjin Key Medical Discipline (Specialty) Construction Project
ID : TJYXZDXK‑016A
Organisme : Tianjin Eye Hospital Science and Technology Fund Youth Cultivation Project
ID : YKPY2201
Informations de copyright
© 2024. The Author(s).
Références
Martinez-Thompson JM, Diehl NN, Holmes JM, et al. Incidence, types, and lifetime risk of adult-onset strabismus [J]. Ophthalmology. 2014;121(4):877–82.
doi: 10.1016/j.ophtha.2013.10.030
pubmed: 24321142
Hertle RW. Natl Eye Inst Sponsored C. A next step in naming and classification of eye movement disorders and strabismus [J]. J Aapos. 2002;6(4):201–2.
doi: 10.1067/mpa.2002.126491
pubmed: 12185342
Peragallo JH, Pineles SL, Demer JL. Recent advances clarifying the etiologies of Strabismus [J]. J Neuroophthalmol. 2015;35(2):185–93.
doi: 10.1097/WNO.0000000000000228
pubmed: 25724009
pmcid: 4437883
Hayashi R, Hayashi S, Machida S. The effects of topical cycloplegics in acute acquired comitant esotropia induced by excessive digital device usage [J]. BMC Ophthalmol, 2022, 22(1).
Ridley-Lane M, Lane E, Yeager LB, et al. Adult-onset chronic divergence insufficiency esotropia: clinical features and response to surgery [J]. J Aapos. 2016;20(2):117–20.
doi: 10.1016/j.jaapos.2015.12.005
pubmed: 26988776
Xia Q, Ling XT, Wang ZH et al. Lateral rectus muscle differentiation potential in paralytic esotropia patients [J]. BMC Ophthalmol, 2021, 21(1).
Mustari MJ, Ono S. Neural mechanisms for smooth pursuit in strabismus [M]//RUCKER J, ZEE D S. Basic and clinical ocular motor and vestibular research. 2011: 187 – 93.
Dakroub M, El Hadi D, El Moussawi Z, et al. Characteristics and long-term surgical outcomes of horizontal strabismus [J]. Int Ophthalmol. 2022;42(5):1639–49.
doi: 10.1007/s10792-021-02159-4
pubmed: 34978651
Mills MD, Coats DK, Donahue SP, et al. Strabismus surgery for adults - a report by the American Academy of Ophthalmology [J]. Ophthalmology. 2004;111(6):1255–62.
doi: 10.1016/j.ophtha.2004.03.013
pubmed: 15177982
Choi YM, Lee JY, Jung JH, et al. Risk factors Predicting the need for additional surgery in consecutive esotropia [J]. J Pediatr Ophthalmol Strabismus. 2013;50(6):335–9.
doi: 10.3928/01913913-20130903-01
pubmed: 24024671
Benson MD, Wozniak J, Macdonald IM. An analysis of strabismus reoperations in Northern Alberta, Canada from 1995 to 2015 [J]. Can J Ophthalmology-Journal Canadien D Ophtalmologie. 2019;54(1):94–7.
doi: 10.1016/j.jcjo.2018.04.007
Wang T, Wang LH. Surgical treatment for residual or recurrent strabismus [J]. Int J Ophthalmol. 2014;7(6):1056–63.
pubmed: 25540765
pmcid: 4270976
Farid MF, Mahmoud MR, Awwad MA. Management of stretched scar- induced secondary strabismus [J]. BMC Ophthalmol, 2020, 20(1).
Leffler CT, Vaziri K, Schwartz SG, et al. Rates of reoperation and abnormal binocularity following strabismus surgery in children [J]. Am J Ophthalmol. 2016;162:159–e669.
doi: 10.1016/j.ajo.2015.10.022
pubmed: 26548808
Oke I, Hall N, Elze T, et al. Adjustable suture technique is Associated with fewer Strabismus reoperations in the Intelligent Research in Sight Registry [J]. Ophthalmology. 2022;129(9):1028–33.
doi: 10.1016/j.ophtha.2022.04.021
pubmed: 35500607
Moen C, Marsh IB. Inferior oblique syndrome: an under-recognised complication of strabismus surgery [J]. Eye. 1998;12:970–2.
doi: 10.1038/eye.1998.251
pubmed: 10325998
Repka MX, Lum F, Burugapalli B, Strabismus. Strabismus surgery, and Reoperation Rate in the United States < i > analysis from the IRIS Registry [J]. Ophthalmology. 2018;125(10):1646–53.
doi: 10.1016/j.ophtha.2018.04.024
pubmed: 29779683
Nowakowska O, Broniarczyk-Loba A, Bogorodzki B. [Consecutive exotropia as a result of esotropia surgery] [J]. Klin Oczna. 1999;101(1):51–4.
pubmed: 10401217
Heo H, Lambert SR. Effect of age on reoperation rate in children undergoing exotropia surgery [J]. Acta Ophthalmol. 2021;99(7):e1206–11.
doi: 10.1111/aos.14771
pubmed: 33529446
pmcid: 10233362
Sun Y, Zhang T, Chen J. Bilateral lateral rectus recession versus unilateral recession resection for basic intermittent exotropia: a meta-analysis [J]. Graefes Arch Clin Exp Ophthalmol. 2018;256(3):451–8.
doi: 10.1007/s00417-018-3912-1
pubmed: 29368040
Chougule P, Kekunnaya R. Surgical management of intermittent exotropia: do we have an answer for all? [J]. BMJ Open Ophthalmol. 2019;4(1):e000243.
doi: 10.1136/bmjophth-2018-000243
pubmed: 30997406
pmcid: 6440598
Oh SY, Park KA, Oh SY. Comparison of recurrent esotropia and consecutive exotropia with horizontal muscle reoperation in infantile esotropia [J]. Jpn J Ophthalmol. 2018;62(6):693–8.
doi: 10.1007/s10384-018-0629-y
pubmed: 30328559
Ruth AL, Velez FG, Rosenbaum AL. Management of vertical deviations after vertical rectus transposition surgery [J]. J Aapos. 2009;13(1):16–9.
doi: 10.1016/j.jaapos.2008.08.015
pubmed: 19117778
Li Y, Zhang W. Focusing on the hot topics of the treatment for intermittent exotropia [J]. Chin J Optometry Ophthalmol Visual Sci. 2018;20(5):4.
Leffler CT, Vaziri K, Schwartz SG, et al. Rates of reoperation and abnormal binocularity following strabismus surgery in children [J]. Am J Ophthalmol. 2016;162:159–66.
doi: 10.1016/j.ajo.2015.10.022
pubmed: 26548808
Rajavi Z, Lashgari A, Sabbaghi H, et al. The incidence of reoperation and related risk factors among patients with infantile exotropia [J]. J Pediatr Ophthalmol Strabismus. 2017;54(1):22–30.
doi: 10.3928/01913913-20160926-02
pubmed: 27783093
Al-Haddad C, Ismail K, Houry R, et al. Recurrence of intermittent exotropia after bilateral lateral rectus recession [J]. Middle East Afr J Ophthalmol. 2020;27(2):123–7.
doi: 10.4103/meajo.MEAJO_188_18
pubmed: 32874046
pmcid: 7442074
Lee JY, Lee GI, Park KA, et al. Long-term evaluation of two reoperation groups for intermittent exotropia [J]. J Aapos. 2017;21(5):349–53.
doi: 10.1016/j.jaapos.2017.05.031
pubmed: 28860030
Bradbury JA, Doran RM. Secondary exotropia: a retrospective analysis of matched cases [J]. J Pediatr Ophthalmol Strabismus. 1993;30(3):163–6.
doi: 10.3928/0191-3913-19930501-08
pubmed: 8350225
Kang X, Wei Y. Formulation of individualized treatment plans for superior oblique palsy based on clinical classification and type [J]. Chin J Optometry Ophthalmol Visual Sci. 2015;17(4):193–6.
Hwang B, Heo H, Lambert SR. Risk factors for reoperation after Strabismus surgery among patients with thyroid Eye Disease [J]. Am J Ophthalmol. 2022;238:10–5.
doi: 10.1016/j.ajo.2021.11.022
pubmed: 34843685
Hashemi H, Pakzad R, Heydarian S, et al. Global and regional prevalence of strabismus: a comprehensive systematic review and meta-analysis [J]. Strabismus. 2019;27(2):54–65.
doi: 10.1080/09273972.2019.1604773
pubmed: 31012389
Wan XM, Wan LQ, Jiang MM et al. A retrospective survey of strabismus surgery in a tertiary eye center in northern China, 2014–2019 [J]. BMC Ophthalmol, 2021, 21(1).