Hemispherotomy can cause post-operative strabismus
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Updated: Jan 19, 2026
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Published on: January 27, 2010
Ayataka Fujimoto1, Tohru Okanishi1, Keishiro Sato1
1Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Japan.
Background:
Hemispherotomy, which involves disconnecting hemispherical fibers, is a treatment option for medically intractable epilepsy. As various neurological disorders can cause strabismus, we hypothesized that hemispherotomy can cause post-operative strabismus in patients with medically intractable epilepsy.
Methods:
Nineteen patients underwent the Hirschberg test before and after hemispherical disconnection surgery. Among the 19 patients, 16 patients (six females and 10 males; mean age, 12.2 years; range, 0.17-43 years) who underwent hemispherotomy were included in this study.
Results:
The difference in the angle between the left and right eyes was significantly widened (p = 0.025). Nine (56%) of 16 patients exhibited post-operative chronic strabismus as evaluated with the Hirschberg test. Intermittent strabismus was noticed by family members or caregivers in 10 (63%) of 16 patients. Patients older than 12 years did not show post-operative strabismus as evaluated by the Hirschberg test.
Conclusion:
Hemispherotomy can cause or worsen post-operative strabismus in pediatric patients.
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