[Strabismus and congenital cataracts]

To study the prevalence, characteristics, indications for and results of strabismus treatment secondary to congenital cataracts.

This was a retrospective study of 21 cases from 29 with congenital cataracts with strabismus (unilateral in 11 and bilateral in 10 cases). In 20 patients surgery on the cataracts was performed, with an intraocular lens inserted in 15 patients. Botulinum toxin and/or strabismus surgery were deemed to be indicated when the deviation was stable after rehabilitation therapy. A good motor end result was considered when the final deviation was < or =5 degrees, and a good sensorial result was when there was no suppression in the Worth test even without stereopsis in the TNO test.

The strabismus prevalence was 72.4%. Strabismus was present before cataract surgery was performed in 12 cases, 8 with esotropia (ET) and 4 with exotropia (XT). Strabismus which appeared after cataract surgery was classified as 13 ET, 5 XT, 1 ET with vertical anisotropia in <>, and 2 XT with dissociated vertical deviation (DVD). The strabismus angle was variable in 6 patients and was not treated. The other 6 cases required strabismus treatment. Botulinum toxin was injected as the only treatment in 1 patient, strabismus surgery was performed in 4, and strabismus surgery and botulinum toxin were used in another case. The average age at the time of treatment was 5.2 years. The motor result was good in 5 cases (83.3%) and the sensorial result good in two (33.3%).

Strabismus secondary to congenital cataracts occurred in a significant number of patients and increased after cataract extraction. Esotropia occurred twice as often as exotropia. Strabismus surgery was not required in most of the cases. The motor results were better than sensorial results.