The management of strabismus in adults--I. Clinical characteristics and treatment.
BACKGROUND
This is the first in a series of articles intended to evaluate the management of strabismus in adults, including clinical outcomes and the quality, cost, and value of treatment from the perspectives of patients and health care providers. Here we present clinical characteristics, complexity of surgery, treatment success, and resolved complaints in a group of adult patients who underwent strabismus surgery.


METHODS
This is a multicenter retrospective study analyzing the type and amount of ocular misalignment before and after surgery in adult patients with strabismus onset before (BVM, or age < 9 years) or after (AVM, or age >/= 9 years) visual maturation. Success was evaluated in terms of alignment, motility, and the presence of diplopia; subjective success was measured in terms of resolved complaints. The complexity of surgery was determined using the Intensity/Complexity Index and compared with success rates.


RESULTS
Data are reported on 299 patients (90 BVM and 145 AVM) whose eyes were successfully aligned in 63% of the BVM cases and 81% of the AVM cases. Subjective complaints resolved at similar rates in the BVM and AVM subgroups. Successful alignment was not correlated with complexity of surgery, but motility and sensory success rates were correlated with complexity of surgery.


CONCLUSIONS
Within each of the BVM and AVM subgroups, this study of adult strabismus showed similar surgical success rates compared with published data. This qualifies these patient groups as clinically typical of adults undergoing strabismus surgery. Additional studies will expand on health value analyses.
Beauchamp
George R
GR
Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, USA.
Black
Bradley C
BC
Coats
David K
DK
Enzenauer
Robert W
RW
Hutchinson
Amy K
AK
Saunders
Richard A
RA
Simon
John W
JW
Stager
David R
DR
Stager
David R
DR
Wilson
M Edward
ME
Zobal-Ratner
Jitka
J
Felius
Joost
J
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods; D012044:Regression Analysis; D012189:Retrospective Studies; D013285:Strabismus / Q000601:surgery*; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology