Journal of American Association for Pediatric Ophthalmology and Strabismus
Major ArticleStrabismus surgery outcome among children and young adults with Down syndrome
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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Cited by (27)
Down syndrome and the eye: Ocular characteristics and ocular assessment
2022, Survey of OphthalmologyConventional surgery versus botulinum toxin injection for the management of esotropia in children with Down syndrome
2022, Journal of AAPOSCitation Excerpt :The success rate from initial surgery was 65%, with a mean surgical recession dose of 5.5 ± 1.3 mm, using standard dosing tables.8-10 Slightly higher success rates for patients with DS using standard dosing tables were previously reported by Yahalom and colleagues10 (86%) and Perez and colleagues9 (76%, not significantly different from 85% in children without DS). In a previous nonrandomized prospective study comparing surgery and BTX for the management of infantile esotropia, stratification by preoperative angle of deviation showed no statistical differences in success rate between treatment groups for angles ≤30Δ (surgery group, 60%; BTX group, 59%), while for angles >30Δ, the success rates of surgery and BTX were 69% and 36%, respectively.13
Infantile esotropias
2016, Taylor and Hoyt's Pediatric Ophthalmology and Strabismus, Fifth EditionEsotropia surgery in children with Down syndrome
2013, Journal of AAPOSCorneal thickness measured by Scheimpflug imaging in children with Down syndrome
2013, Journal of AAPOSCitation Excerpt :In previous studies authors have demonstrated that children with Down syndrome are at risk for ocular disorders such as refractive error, strabismus, cataract, and glaucoma. Glaucoma is less common than other ocular disorders, but it has serious visual implications.9-14 Although the prevalence of glaucoma is as low as 1.9%9 in children with Down syndrome, it is 11.5% in an adult Down syndrome group.10