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Strabismus in unicoronal synostosis: ipsilateral or contralateral?
Claire Macintosh1, Steve Wall, Carolyn Leach
1Oxford Craniofacial Unit, Oxford Radcliffe Hospitals NHS Trust, John Radcliffe Hospital, Oxford, United Kingdom. Claire.macintosh@orh.nhs.uk
The Journal of Craniofacial Surgery
|June 1, 2007
Summary
Strabismus in unicornal synostosis (a premature suture fusion) is common but not more likely on the side of the fused suture. Refractive errors like astigmatism also occurred more frequently on the non-fused side.
Area of Science:
- Ophthalmology
- Pediatric Neurosurgery
- Genetics
Background:
- Unicoronal synostosis, a premature fusion of one coronal suture, is associated with an increased prevalence of strabismus.
- Existing literature suggests strabismus in these patients is typically a hypertropia ipsilateral to the fused suture.
Purpose of the Study:
- To investigate the laterality of strabismus in unicornal synostosis.
- To report on ocular motility and refractive findings in a large, unbiased sample.
Main Methods:
- Retrospective case study analysis of 59 patients with unicornal synostosis.
- Reviewed over a 14-year period at the Oxford Craniofacial Unit.
- Analysis of strabismus laterality, ocular motility, and refractive errors.
Main Results:
- Manifest strabismus found in 57.6% of cases, with no statistically significant preference for the ipsilateral or contralateral side (P=0.0872).
- Esotropia with a vertical component was most common (61% of strabismus cases).
- Significant refractive errors, including anisometropia and astigmatism, were more frequent on the contralateral side (P=0.0106).
Conclusions:
- The laterality of strabismus in unicornal synostosis is not definitively ipsilateral to the fused suture.
- Ocular motility issues and refractive errors, particularly astigmatism, are common and may favor the non-fused side.
- FGFR2/FGFR3 gene mutations were associated with manifest strabismus.
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