Purpose

To describe the rates of strabismus, strabismus surgery, and strabismus surgery reoperations among all age groups in the United States.

Design

Retrospective analysis of electronic health record data.

Participants

Patients from the IRIS (Intelligent Research in Sight) Registry.

Methods

Description of the types and rates of strabismus and strabismus surgery from 2013 to 2016 with subgroups by age, sex, race/ethnicity, and region of the United States.

Main Outcome Measure

The 1-year reoperation rate for strabismus surgery performed during 2013–2015 for all age groups.

Results

A total of 30 827 185 unique patients were identified; 846 477 (2.75%) had a diagnosis of strabismus: 3.02% of male patients and 2.55% of female patients (difference = 0.47%, 95% confidence interval [CI], 0.46–0.48, P < 0.0001). Strabismus surgery was performed in 40 780 (0.13%) unique patients during the 4 years. The rate of surgery ranged from 1.99% for children birth to 5 years of age to 0.05% for adults 40 years of age and older. Horizontal surgical codes were reported 38 813 times, vertical surgery codes were reported 9304 times, and superior oblique codes were reported 711 times. Adjustable sutures were used for 3027 patients (7.42%). Cases with a code for repeat eye muscle surgery or restrictive myopathy were reported for 6098 patients (14.9%). Esotropia accounted for 30.06% and exotropia in 21.77% of diagnoses reported for surgery. The rate of undergoing a reoperation within 1 year of a strabismus surgery was 6.72%, lowest for the group 6 to 9 years of age (3.95%) and increasing with age (P < 0.001) to 11.5% for patients 65 years of age and older.

Conclusions

Strabismus is an uncommonly reported diagnosis in ophthalmologic practice. Overall, approximately 1 in 750 patients in the IRIS Registry received strabismus surgery (1 in 20 with a strabismus diagnosis) during a 4-year period. Reoperations during the first year after surgery were performed for 1 in 15 patients, increasing with age at surgery. “Big” data from clinical data registries represent real-world care that can be used to develop benchmarks for clinical outcomes and to identify areas for practice improvement and training program design.

中文翻译：

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美国的斜视，斜视手术和再手术率

目的

描述美国所有年龄段的斜视，斜视手术和斜视手术再手术的发生率。

设计

电子病历数据的回顾性分析。

参加者

来自IRIS（智能视力研究）注册中心的患者。

方法

按年龄，性别，种族/民族和美国地区分组的2013年至2016年斜视和斜视手术的类型和发生率的描述。

主要结果指标

2013年至2015年期间，所有年龄段的斜视手术的1年再手术率。

结果

总共确定了30 827 185名独特患者；846 477（2.75％）诊断为斜视：男性患者为3.02％，女性患者为2.55％（差异= 0.47％，95％置信区间[CI]，0.46-0.48，P<0.0001）。在这4年中，对40 780（0.13％）位独特的患者进行了斜视手术。手术率从出生至5岁儿童的1.99％到40岁及以上成年人的0.05％不等。报告水平手术规范38 813次，报告垂直手术规范9304次，上斜法规范711次。3027例患者使用了可调缝线（7.42％）。据报道有6098例患者（14.9％）患有重复性眼肌手术或限制性肌病的法规。据报道手术诊断中，内斜视占30.06％，外斜视占21.77％。斜视手术后1年内再次手术的发生率为6.72％，在6至9岁年龄组中最低（3.95％），并且随着年龄的增长而增加（P 65岁及以上的患者的<0.001）至11.5％。

结论

斜视是眼科实践中罕见的诊断报告。总体而言，在IRIS注册中心中，约750名患者中有1名在4年期间接受了斜视手术（每20名中有1名患有斜视）。手术后第一年中，每15例患者中有1例进行了再次手术，并随着年龄的增长而增加。来自临床数据注册中心的“大”数据代表了现实世界中的护理，可用于制定临床结果的基准并确定实践改进和培训计划设计的领域。