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Outcome of surgery for esotropia in children with down syndrome
Insights
Surgery for esotropia in children with Down syndrome yielded outcomes comparable to infantile esotropia. While some residual esotropia occurred, counseling parents on expected outcomes is advised.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Genetics
Background:
- Esotropia surgery outcomes in children with Down syndrome are understudied.
- Down syndrome is associated with various health conditions, including strabismus.
Purpose of the Study:
- To evaluate the motor outcomes of esotropia surgery in pediatric patients with Down syndrome.
- To compare these outcomes with those in other pediatric esotropia populations.
Main Methods:
- Retrospective review of 21 pediatric patients with Down syndrome who underwent esotropia surgery between 1991 and 2001.
- Analysis of pre- and post-operative deviation, need for reoperation, and follow-up duration.
Main Results:
- Mean age at surgery was 55 months with a mean preoperative esotropia of 36 prism diopters.
- Three patients required reoperation; two for residual esotropia, one for consecutive exotropia.
- At a mean follow-up of 39 months, 14 patients had a deviation of 0-10 prism diopters, with most remaining esotropic.
Conclusions:
- Surgical outcomes for esotropia in Down syndrome are less favorable than in acquired esotropia but comparable to infantile esotropia.
- Higher rates of residual esotropia suggest a need for tailored surgical approaches or acknowledge underlying tendencies in Down syndrome.
- Parents can be informed about the generally positive, though variable, outcomes of esotropia surgery in this population.
Background And Purpose:
The outcome of surgery for esotropia in children with Down syndrome has not received significant attention.
Patients And Methods:
We reviewed motor outcomes of esotropia surgery in all patients with Down syndrome in our practice from 1991-2001.
Results:
Twenty-one patients had surgery for esotropia. The mean age at surgery was 55 months. The mean preoperative esotropia was 36(Δ). Three patients required a second surgery: two for residual esotropia and one for consecutive exotropia. A second operation was recommended for two additional patients: one with residual esotropia and one with consecutive exotropia. The mean length of follow-up was 39 months. At the last follow-up examination, fourteen patients had a deviation of 0-10(Δ) (thirteen esotropic and one exotropic). Five patients had a final deviation of 11-20(Δ) (four esotropic and one exotropic). One patient had a residual esotropia of 21-30(Δ) and one had greater than 30(Δ) of residual esotropia.
Conclusion:
The motor outcomes for esotropia surgery in children with Down syndrome were not as good as those in children with acquired esotropia but were comparable to those in children with infantile esotropia. More children had residual esotropia than consecutive exotropia, which may reflect a tendency toward conservative amounts of surgery or an underlying esotropic tendency in Down syndrome. Parents of children with Down syndrome may be counseled to expect good outcomes in the surgical management of esotropia.
