Outcome of horizontal strabismus surgery and parents’ satisfaction

Abstract

Introduction: A clinical audit of strabismus surgery in children in terms of functional and cosmetic outcomes helps improve the quality of services in pediatric ophthalmology.  Objective: To evaluate the outcome of strabismus surgery and assess the satisfaction of the patients’ parents with respect to the surgery outcome.Subjects and methods: A study of an interventional series of cases that included 60 strabismic subjects was carried out. The bilateral strabismus surgery under general anesthesia was performed on all subjects using the fornix approach. The parents’ understanding about strabismus and the cosmetic outcome was assessed through a set of interview questionnaires. The main outcome measures were the amount of deviation, the parents’ knowledge about strabismus and their satisfaction after the intervention. Results: Of the 60 subjects, 32 (53.3%) were esotropic and 28 (46.7%) exotropic. The male to female ratio was 1:1. The mean age with standard deviation was 16.6±8.5years,with a range of 3 to 35 years. The pre- operative mean esotropia with standard deviation was 48.2±14.8 pd, with a range of 22 to 114 pd). The pre-operative mean exotropia was 57.8±14.2 pd, with a range of 25 to 90 pd). In 93.47% of the subjects, the ocular deviation after surgery reduced significantly (p=<0.00). After the strabismus surgery, orthophoria was achieved in 15 (25%) subjects, and with excellent cosmetics. After surgery, gross binocular single vision was attained in 39.3% of the exotropes and in 17.9% of the esotropes. Only 30 % of the parents were aware about the strabismus and the treatment modalities. Nearly 90% of the parents were satisfied with the cosmetic outcome. Conclusion: Horizontal and bilateral strabismus has good surgical outcome with improved cosmetic acceptance.DOI: http://dx.doi.org/10.3126/nepjoph.v6i2.11704Nepal J Ophthalmol 2014; 6(12): 162-169