ABSTRACT

Objective

To study the success rate of strabismus surgery in patients with varying levels of severity of cerebral palsy (CP).

Design

A retrospective study was conducted.

Participants

Sixty-four patients with varying severity of CP were included.

Methods

All patients with different CP severity levels underwent strabismus surgery. Success was defined as any postoperative heterotropia outcome of less than 10 prism diopters in primary position. Statistical analysis was conducted using chi-square.

Results

The mean age at the time of strabismus surgery was 3.1 years, and the mean follow-up was 6.0 years. The most common types of strabismus were infantile-onset exotropia in 36 patients (56%) and infantile-onset esotropia in 28 patients (44%). Surgical success was found to be better in patients with mild GMFCS (GMFCS levels 1–2) with 68% having less than 10 PD of eso or exotropia in primary gaze, as compared to patients with severe GMFCS (GMFCS levels 3–5) (38% with 10 PD of heterotropia) (P < .05; χ2). Refractive errors included myopia (27.5% in mild cases and 41.6% in severe), emmetropia (10% in mild and 8.3% in severe) and hyperopia (62.5% in mild and 50% in severe). Around 50% of the mild cases had absent binocular fusion compared to 66.6% of those with severe CP. Amblyopia was found in 62.5% of the mild cases and 54.1% of the severe cases. Nystagmus was present in 25% with mild disease and 29.1% of those with severe disease.

Conclusion

Restoration of good ocular alignment in patients with CP is achievable in more than half of the cases. Patients with more severe CP have poorer outcomes than those with milder palsies. There appears to be no difference in outcomes between the different types of strabismus.

中文翻译：

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不同严重程度脑瘫儿童的斜视修复

摘要

客观的

研究不同严重程度脑瘫（CP）患者斜视手术的成功率。

设计

进行了一项回顾性研究。

参与者

包括 64 名 CP 严重程度不同的患者。

方法

所有 CP 严重程度不同的患者均接受了斜视手术。成功被定义为主要位置小于 10 棱镜屈光度的任何术后异斜视结果。使用卡方进行统计分析。

结果

斜视手术时的平均年龄为 3.1 岁，平均随访时间为 6.0 年。最常见的斜视类型是 36 例 (56%) 的婴儿型外斜视和 28 例 (44%) 的婴儿型内斜视。与严重 GMFCS 患者（GMFCS 水平 3-5）相比，轻度 GMFCS 患者（GMFCS 水平 1-2）的手术成功率更高，其中 68% 的患者初次凝视时内斜或外斜视的 PD 小于 10 次。 38% 有 10 PD 异向性) ( P< .05; χ2)。屈光不正包括近视（轻度为 27.5%，重度为 41.6%）、正视（轻度为 10%，重度为 8.3%）和远视（轻度为 62.5%，重度为 50%）。大约 50% 的轻度病例没有双眼融合，而重度 CP 的这一比例为 66.6%。62.5%的轻度病例和54.1%的重度病例出现弱视。25% 的轻度疾病和 29.1% 的重度疾病存在眼球震颤。

结论

一半以上的 CP 患者可以恢复良好的眼对线。患有更严重 CP 的患者比患有轻度麻痹的患者预后更差。不同类型的斜视之间的结果似乎没有差异。