Major Article
Strabismus surgery outcome among children and young adults with Down syndrome

https://doi.org/10.1016/j.jaapos.2010.01.009Get rights and content

Purpose

To evaluate postoperative alignment after strabismus surgery in children with Down syndrome.

Methods

A retrospective analysis of 15 consecutive cases of children with Down syndrome who underwent surgery for strabismus between 1990 and 2008. Follow-up was at least 6 months (range, 0.5-16 years).

Results

All children underwent surgery for esotropia. The mean preoperative angle of deviation was 37.6Δ. Of the 15 children, 14 underwent surgical procedure for strabismus according to standard surgical tables. Surgical success (within 10Δ of orthophoria) was achieved in 12 of 14 children (85.7%). The remaining 2 children (14.3%) had residual esotropia.

Conclusions

Good surgical motor outcomes were achieved in children with Down syndrome after strabismus surgery following standard surgical tables. The tendency toward overcorrection reported in children with central nervous system disorders was not observed in our study. We suggest use of the same surgical calculations as used in children with normal development when treating children with Down syndrome and esotropia.

Section snippets

Subjects and Methods

All files of children with Down syndrome who underwent eye examination in our institution between 1990 and 2008 were reviewed; 111 children were identified, of whom 15 had undergone surgery for esotropia and met all inclusion requirements for our study. Exclusion criteria were strabismus secondary to other eye pathology, previous eye/muscle surgery, or postoperative follow-up of less than 6 months. Mean age at surgery was 6.2 years (range, 1.2-24.9 years).

All children underwent comprehensive

Results

Strabismus was found in 47 of 111 children with Down syndrome (42%). Of these, 7 children were excluded because of strabismus secondary to other intraocular abnormalities. Of the remaining 40 children, 39 had esotropia, and 1 had exotropia. Only 16 children underwent surgery, of whom 1 was excluded because of short follow-up.

All 15 children included in our study were operated on for esotropia; 14 had infantile esotropia; and 1 child had partially accommodative esotropia. Mean angle of esotropia

Discussion

The purpose of our study was to evaluate the motor response of children with Down syndrome who underwent esotropia surgery. We found good postoperative alignment, which remained stable during follow-up period of at least 6 months, in 15 children with Down syndrome.

Several groups have evaluated the results of strabismus surgery in children with developmental delay. Some of the children included in these studies were children with Down syndrome.9, 10, 11 Pickering and colleagues9, 10 showed a

Literature Search

PubMed was searched for the following terms: Down syndrome, esotropia, and surgery.

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