Clinical risk factors and management of consecutive strabismus


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Article type :

Original Article

Author :

Reena Gupta, Jyoti Deswal, Seemanchal Goel, Chekitaan

Volume :

5

Issue :

4

Abstract :

Material and Methods: The study was conducted at Pediatric Ophthalmology and Strabismus clinic at our tertiary care institute PGIMS, Rohtak. Patients who developed consecutive tropia after squint surgery for horizontal strabismus from April 2015 to August 2016 were enrolled. Continued esodeviation after surgery for exotropia was termed as consecutive esotropia and post-operative exodeviation present even 2 weeks after surgery for esotropia was termed as consecutive exotropia. The patients were followed up for at least 3 months. Ocular movements, preoperative deviation (PBCT), presence of vertical deviation, DVD, A-V patterns was noted, AC/A ratio, sensory status by Worth Four Dot Test and Titmus test. Immediate post-operative deviation was measured. Follow-up was done at 2 weeks, 6 weeks, 3 months and 6 months. Results: There were a total of 92 patients who underwent squint surgeries for horizontal strabismus. 12 patients developed consecutive squint. Out of 12 patients, 10 patients developed consecutive exotropia and 2 patients developed consecutive esotropia. The mean pre-operative deviation of resolved cases in both the groups was 458.16PD for near and 42.58.66PD for distance and the mean pre-operative deviation of unresolved cases in both the groups was 39.1610.68PD for near and 38.336.83PD for distance. Discussion: In our study, the incidence of consecutive squint was 13%. Out of which 10.86% had consecutive exotropia and 2.17% had consecutive esotropia. The patients who developed consecutive squint had infantile esotropia, infantile exotropia, partially accommodative esotropia and non- accommodative acquired esotropia. Amongst consecutive exotropias group, 40% cases resolved while in consecutive esotropia group, 50% resolved. Conclusion: Consecutive squint is a complication of squint surgery which can develop immediately after surgery or years later. Taking care of the errors during measurement of pre-operative deviation improves the success of surgical outcomes.

Keyword :

 Consecutive squint, Horizontal strabismus, DVD, Esodeviation, Exodeviation, Consecutive esotropia, Consecutive exotropia.