La incidencia de estrabismo adquirido del adulto no asociado con problemas paralíticos está en aumento. Existe una fuerte asociación entre los trastornos de la. Esotropia with nystagmus” is a distinct congenital or infantile syndrome, whose analysis revealed the following three elements: 1. Pathological convergence. La prevalencia del estrabismo se estima en torno a un % de la población, con una presencia 3 veces superior de endotropía frente a la.
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Retrospective cross-sectional review of medical records of patients who underwent strabismus surgery performed by the same surgeon from to Incomplete records were excluded from the study.
Variables included sex, age, type of strabismus, type of surgery, and re-surgeries. Strabismus was classified into three main types esotropia, exotropia, and pure vertical deviationand their subtypes. The type of surgery was determined by the number of muscles operated on up to two, or more than twothe involvement of oblique and vertical rectus muscles, and muscle displacement.
The average age was The most frequent subtype of esotropia was infantile Constant exotropia was the most frequent subtype of exotropia The prevalence of esotropia decreased with age, whereas that of exotropia increased. An association between different types of deviation was found in Re-surgeries accounted for Esotropias were the most common types of strabismus, especially infantile esotropia.
Most cases were associated with other types of deviation, and needed more complex surgeries, involving more than two muscles. This study expects to contribute to the planning of health measures that may effectively improve the assistance provided to the population. Treatment for strabismus may be either clinical, optical, or involving an association of techniques, and its purpose is to preserve and ensure adequate visual development, recover binocular vision, and establish ocular parallelism.
It has been found that children with strabismus are viewed negatively, and that surgery could lead to psychosocial benefits, even when there is no hope of improving visual function. The global medical literature found frequencies ranging from 0. The purpose of this study is to determine the prevalence of the different types of strabismus submitted to surgical procedures in a public hospital of the Brazilian Federal District.
Patients submitted to surgical procedures to correct strabismus including those with application of botulinum toxin were included in the study, regardless of age or sex.
Pan-American Association of Ophthalmology
Parraliticos surgical procedure performed in that period was evaluated and recorded as a case for the study. Patients whose medical records did not possess all the necessary information were excluded from the research.
The researched variables included sex, age at the time of surgery, type of surgery and classification of strabismus. Strabismus was classified into three main types: ET, XT, and pure vertical deviation.
Their subtypes are presented in Table 1. The definitions used in the study followed proposals made by several authors. The type of surgery was determined by the number of muscles operated on intervention in up to two muscles, or intervention in more than two muscles. The involvement of oblique and vertical rectus muscles, the displacement of the rectus muscle, and the number of re-surgeries were also considered.
Patients were grouped into age brackets according to their ages at the time of surgery, and following the same division employed in the study of Curtis et al. A descriptive statistical analysis was conducted through the use of frequency distribution tables for each variable studied. Patients were grouped into age brackets according to their ages at the time of surgery, and following the same division employed in the study of Curtis et all. XT accounted for Among the patients who underwent surgery before they were 10 years old, that ratio was 5.
Constant XT was the paraliiticos common The same number of patients presented with intermittent and sensorial XT An association with at least one more type of deviation was seen in Among XT patients, vertical deviations It is difficult to compare the findings of the present study to other research, due to the methodological variability across the studies, to the fact that few studies investigated surgical strabismus alone, 13, 14and to the lack of standardization in the classification of estrabismow.
Furthermore, most of the research is either population-based, or limited to a specific age bracket 13, A possible explanation for this difference may be the fact that surgery is not recommended for several cases of intermittent XT, which are, however, still accounted for in population-based studies. Although infantile ET is classically indicated as the most common type of esotropia among children, in recent studies this high prevalence has not been found. Additionally, most cases of accommodative ET may be corrected with plus lenses 11, 19 and do not need surgery, therefore not being widely represented among the subjects of this study 11,19 Regarding XT subtypes, we found trends similar to those found in other studies.
In addition, the study found a high rate of sensorial XT Among the cases of paralytic strabismus, the most affected cranial nerve was the sixth, corroborating the data found in the literature. This number is lower than the one seen in the literaturewhich might be due to good results obtained by the first surgery, to a difficulty faced by patients in following up on their treatments due to socioeconomic issues, or to lower standards regarding esthetic results among the population under study New studies will be necessary in order to clarify esstrabismos finding.
Most surgical cases showed associated deviations, which renders programming and performing the surgery more complex. This has also contributed to the fact that over half the surgeries needed interventions in more than two extraocular muscles. As previously demonstrated, surgeries performed in more than two muscles take longer than those performed in up to two muscles, 14decreasing the number of surgeries that may be performed in the same period Likewise, we observed that there was an increased demand for surgeries involving oblique muscles, vertical rectus muscles and displacement techniques.
These surgeries require a more elaborated planning and are technically more difficult. This observation may demonstrate the importance of the surgeon being prepared to perform different techniques in several extraocular muscles.
Professionals with a less specific paraloticos in the treatment of strabismus may feel that they are only able to operate the simplest cases, usually involving rectus and horizontal muscles only. This may either reflect a difficulty in gaining quick access to healthcare services, or a lack of qualified estrabismoa and resources to perform an earlier surgery; further research is needed for a better understanding of wstrabismos issue. Factors influencing the successful outcome and response in strabismus surgery.
Negative social bias against children with strabismus. Psychosocial aspects of strabismus study. Eshrabismos of strabismus and amblyopia in 1. Refractive Error Study in Children: Prevalence and outcomes of childhood visual disorders. J Pediatr Ophthalmol Strabismus. Common forms of childhood exotropia.
National Eye Institute; Epidemiology of surgical strabismus in Saudi Arabia. Matsuo T, Matsuo C. The prevalence of strabismus and amblyopia in Japanese elementary school children.
Prevalence of squints and visual defects in Malaysian primary one school children. Long-term observations on unoperated intermittent exotropia. Common forms of childhood strabismus in an incidence cohort. Incidence and types of childhood esotropia: Incidence and types of childhood exotropia: Acquired palsy of the oculomotor, trochlear and abducens nerves.
.: Portal da SBO – Sociedade Brasileira de Oftalmologia :.
Acquired oculomotor, trochlear, and abducent cranial nerve palsies in pediatric patients. Long-term motor and sensory outcomes after early surgery for infantile esotropia.
Results of early alignment of congenital esotropia. The relationship between preoperative alignment stability and postoperative motor outcomes in children with esotropia. Strabismus surgery learning paraltiicos ophthalmology residents of university service. Final report of the early vs. Original Articles Revista vol. Introduction Treatment for strabismus may be either clinical, optical, or involving an association of techniques, and its purpose is to preserve and ensure adequate visual development, recover binocular vision, and establish ocular parallelism.
Results surgeries were performed in the period under study. Discussion It is difficult to compare the findings of the present study to other research, due to the methodological variability across the studies, to the fact that few studies investigated surgical strabismus alone, 13, 14and to the lack of standardization in the classification of strabismus. Common forms of childhood esotropia.
Revista Brasileira de Oftalmologia. Leia na Palavra do Presidente.