title: Outcomes of strabismus surgery for esotropia in children with Down syndrome compared with matched controls.
abstract: OBJECTIVE
  Strabismus surgery dosages used in children with various neurodevelopmental disorders have been the subject of controversy. Few data have been reported regarding surgical results in individuals with Down syndrome (DS).
  
  
  METHODS
  A retrospective, case-control study was performed in which children with DS and previous bilateral medial rectus recession surgery were matched with similar control patients without DS. Surgical results were compared using a random coefficients model for repeated measurements for each group.
  
  
  RESULTS
  Sixteen patients with DS were matched with 16 control patients. Mean preoperative esotropia was 28.4 prism diopters (PD) in the DS group and 27.9 PD in the control group. No significant difference was found in surgical dosages between the two groups (P = .2402). Median surgical dosage was 4.4 mm in the DS group and 4.5 mm in the control group. Preoperative and 4-month and 24-month postoperative mean angles of esotropia were not different between groups (P = .8050). The 4-month postoperative mean angles of esotropia for the DS and control groups were 3.15 and 2.66 PD, respectively. The 24-month mean angles of esotropia for the DS and control groups were 7.09 and 6.60 PD, respectively.
  
  
  CONCLUSIONS
  Standard bilateral medial rectus recession surgical dosages need not be modified for individuals with DS.
authors.affiliation: Cincinnati Children’s Hospital Medical Center, Division of Pediatric Ophthalmology, 3333 Burnet Avenue, MLC 4008, Cincinnati, OH 45229, USA. william.motley@cchmc.org
authors.forename: W Walker
authors.initials: WW
authors.lastname: Motley
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Melson
authors.forename: Michael E
authors.initials: ME
authors.lastname: Gray
authors.forename: Shelia R
authors.initials: SR
authors.lastname: Salisbury
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000503:physiopathology / Q000601:surgery*; D004948:Esotropia / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D017063:Outcome Assessment, Health Care; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology