The Outcome of Strabismus Surgery and Influencing of Surgical Success at Children Surgical Center, Cambodia

Main Article Content

Soryoun Soeung
Amarin Mar
Kossama CHUKMOL

Abstract

Introduction: Strabismus is a condition in which the eyes are not properly aligned with each other. It may be accompanied by abnormal motility of one or both eyes with multifactorial factors including both genetic and environmental. A surgical treatment is one of the options.


Objective: To determine the outcome of surgery treatment of strabismus patients.


Methods: It was a cross sectional study conducted in Department of Ophthalmology at Children’s surgical center that located in Kien Khleing National Rehabilitation Center, Phnom Penh, Cambodia from January 2009 to October 2014 with the sample size of 269 cases. All surgeries were conducted under general anesthesia, following routine pediatric techniques. Horizontal squint surgery was performed as the first surgery, using standard surgical dosage tables without modification.


Results: There were totally 269 strabismus cases consisting 34% male and 66% female found in this study. 91.82% of the cases were seen in the age group from 0-9 years. 59% of cases were considered as congenital (onset before 6 months old) against 41% of acquired strabismus (onset after 6 months old). 92% of the cases were treated by horizontal surgery whereas other 4% were vertical squint (2%) and torsional (2%). There were 68% of cases had orthotropia (fully corrected), 24% had undercorrected esotropia, 6% had undercorrected exotropia and 2% had overcorrected. The Majority of cases had successful surgery treatment without complication. However, there were some complication seen such as 1% of diplopia, 2% of re-operation and 0.37% of scleral perforation.      


Conclusion: In conclusion to this study, we found that strabismus was affected in female more than male. Children from 0-9 years old are the most commonly seen in term of age. There was highest number of cases recorded from Kampong Cham province than other provinces. There were 96% of had surgery treatment and got better outcome and the complication was noted in just 3.5% of cases.

Article Details

Section
Original Study

References

McKean-Cowdin, R., Cotter, S. A., Tarczy-Hornoch, K., Wen, G., Kim, J.et al. (2013). Prevalence of Amblyopia or Strabismus in Asian and Non-Hispanic White Preschool Children. Ophthalmology , 2117-2124.

Coats, D. K., Stager, D. R., Beauchamp, G. R., Stager Jr, et al. (2005). Reasons for Delay of Surgical Intervention in Adult Strabismus. Archives of Ophthalmology , 497-499.

Rutstein, R. P., & Daum, K. M. (1998). Anomalies of Binocular Vision: Diagnosis & Management. St. Louis: Mosby.

Maconachie, G. D., Gottlob, I., & McLean, R. J. (2013). Risk Factors and Genetics in Common Comitant Strabismus. Journal of American Medical Association Ophthalmology , 1179-1186.

Engle, E. C. (2007). Genetic Basis of Congenital Strabismus. Archives of Ophthalmology, 189-195.

Sanfilippo, P. G., Hammond, C. J., Staffieri, S. E., et al. (2012). Heritability of Strabismus: Genetic Influence Is Specific to Eso-Deviation and Independent of Refractive Error. Twin Reasearch and Human Genetics , 624-630.

Hatt, S. R., Leske, D. A., Kirgis, P. A., (2007). The Effects of Strabismus on Quality of LIfe in Adults. American Journal of Ophthalmology , 144, 643-647.

Jane CC Yeung. Medical Bulletin. The Hong Kong Medical Diary. VOL.15 NO.10 OCTOBER 2010

Akiko Tanaka, Kyoko Ohno-Matsui, Noriaki Shimada, Kengo Hayashi, Yuko Shibata,et al,. Prevalence of Strabismus in Patients with Pathologic Myopia. J Med Dent Sci 2010; 57: 75-82.

Amberin Fatima Fazal. Review of outcome of horizontal childhood strabismus surgery at Kenyatta national hospital and Kikuyu eye Unit, A restrospective. DISSERTATION OF THE UNIVERSITY OF NAIROBI. 2012.

Shawky RM, El-Sawi M, El-Hawary G, Azeem AA. A genetic study of primary strabismus among Egyptians. Egyptian J Pediatr. 1990; 7(1-2):89-106.

AbbasAli Yekta, Hassan Hashemi, Elham Azizi, Farhad Rezvan, Hadi Ostadimoghaddam, Akbar Derakhshan, MD7 Abbas Azimi, Mehdi Khabazkhoob, Ali Akbar Khadem Maboudi. The Prevalence of Amblyopia and Strabismus among Schoolchildren in Northeastern Iran, 2011. Iranian Journal of Ophthalmology 2012;24(4):3-10 by the Iranian Society of Ophthalmology.

Chia A, Dirani M, Chan YH, Gazzard G, Au Eong KG, Selvaraj P, Ling Y, Quah BL,Young TL, Mitchell P, Varma R, Wong TY, Saw SM. Prevalence of amblyopia and strabismus in young singaporean chinese children. Invest Ophthalmol Vis Sci 2010; 51: 3411-7.

Multi-ethnic Pediatric Eye Disease Study Group. Prevalence of amblyopia and strabismus in African American and Hispanic children aged 6 to 72 months, Ophthalmology 2008; 115: 1229-1236. 7.

Friedman DS, Repka MX, Katz J, Giordano L, Ibironke J, Hawse P, Tielsch JM. Prevalence of Amblyopia and Strabismus in White and African-American Children Aged 6 through 71 Months: The Baltimore Pediatric Eye Disease Study. Ophthalmology 2009; 116: 2128-34.

Pathai S, Cumberland PM, Rahi JS. Prevalence of and early-life influences on childhood strabismus: findings from the Millennium Cohort Study. Arch Pediatr Adolesc Med 2010; 164: 250-7.

Hatt SR, Gnanaraj L. Interventions for intermittent exotropia. Cochrane Database of Systematic Reviews 2013, Issue5.Art.No.: CD003737.DOI:10.1002/14651858.CD003737.pub3.

KampanartsanyakornS, SurachatkumtonekulT, DulayajindaD, JumroendararasmeeM, Tongsae S.The outcomes of horizontal strabismus surgery and influencing factors of the surgical success. J Med Assoc Thai. 2005 Nov;88 Suppl 9:S94-9.

Yahalom C1, Mechoulam H, Cohen E, Anteby I. Strabismus surgery outcome among children and young adults with Down syndrome. J AAPOS. 2010 Apr;14(2):117-9. doi: 10.1016/j.jaapos.2010.01.009.

Sabina Shrestha1 , Aparajita Manoranjan1 , Sushan Shrestha2 . Surgical outcome of strabismus. MJSBH July-December 2013|Vol 12| Issue 2.

Dayane Cristine Issaho , Marcia Keiko Uyeno Tabuse ,NilceTiemi Shiwaku Kamida , Monica Fialho Cronemberger. Surgical results of strabismus correction in patients with myelomeningocele.Arq.Bras.Oftalmol. vol.78 no.1 São Paulo Jan./Feb. 2015.

Rogers GL, Chazan S, Fellows R, Tsou BH. Strabismus surgery and its effects upon infant development in congenital strabismus. Ophthalmology. 1982;89:479-83.

Paula M. Edelman, C.O. Functional benefit of adult strabismus surgery. Amer. Orthoptic J.2010;(60):143-7

SatterÞ eld D, Keltner JL, Morrison TB. Psycholosocial aspects of strabismus study. Arch

Ophthalmol. 1993;111:1100-5.

Kushner BJ, Morton GV. Postoperative binocularity in adults with longstanding strabismus. Ophthalmology. 1992;99:316-9.

Thomas S., Guha S. Large angle strabismus: Can a single surgical procedure achieve a successful outcome? Strabismu. 2010;18(4):129-36.

Acun Gezer, Fazil Sezen, Nail Sahri, Nilufer Gozum. Factors inß uencing the outcome of strabismus surgery in patients with exotropia. JAAPOS.2004;8(1):56-60.

Mets MB, Beauchamp C, Haldi BA. Binocularity following surgical correction of strabismus in adult. Trans Am Ophthalmol Soc. 2003;101:201- 7. PMid:14971578.

Garabaghi D, Azadeh M. Binocular vision and stereopsis following delayed strabismus surgery. Iranian Journal of Ophthalmology. 2006;19(2):46- 50.