Influence of Age and Underlying Etiologies on Outcomes of Strabismus Surgery in the Elderly Population.

Abstract

PURPOSE To investigate the success of strabismus surgery in older adults and determine the impact of age and underlying etiology on surgical outcomes. METHODS Retrospective review of medical records of patients aged 60 years or older who underwent strabismus surgery at a tertiary eye care center. Surgical motor and sensory outcomes were analyzed. RESULTS Of the 562 that met criteria, patients were mostly female (56.1%) with a mean age of 71.7 ± 6.6 years. The majority of patients reported diplopia (85.9%). The most frequent etiologies were paralytic (27.9%), adult-onset esotropia (19.0%), and thyroid eye disease (16.4%). Following initial surgery, motor and sensory surgical success rates were 65.1% and 62.9%. No significant differences in mean age were observed based on sensory success (P=.8529), motor success (P=.1670), or etiology (P=.1069). Etiology was associated with motor and sensory success (P=.0160 and P=.0001, respectively). Adult-onset basic esotropia had higher rates of motor and sensory success (P=.0091), and convergence insufficiency exotropia and recurrent or consecutive strabismus had higher rates of sensory success (P=.0029 and P=.0393, respectively). Among demographic and pre-operative characteristics, etiology (P=.0008) predicted sensory success, and etiology (P=.0670) and use of adjustable sutures (P=.0003) predicted motor success. Patients who received adjustable sutures had significantly higher odds (OR = 2.15; 95% CI, 1.42-3.25) of motor success. Motor and sensory success rates improved to 78.1% and 73.3% after reoperation in 82 patients (14.6%). CONCLUSIONS Etiology was found to be predictor of sensory success, while both etiology and use of adjustable sutures were predictors of motor success. Surgical success was not influenced by increasing age.