The authors present a retrospective case review of the outcomes of combined strabismus and cataract surgery in adults with longstanding horizontal manifest strabismus and visually significant cataracts. A minimum of 1-month follow-up was required to be included. Cases with sensory, paretic and mechanical strabismus, significant vertical strabismus and/or other ocular pathology were excluded. The following data was extracted from the records: visual acuity, angle of deviation, sensory fusion, fundus and media findings. A total of 34 individuals (40 eyes) treated over a 2-year period were included in the analysis. The majority of eyes were exotropic (n=34), had manual small incision cataract surgery (n=26) and were in the large-angle group (>45Δ) (n=22). A total of 6 individuals had bilateral combined surgery. All eyes were reported to have had good visual outcomes (0.3LogMAR or better), and 88% of patients achieved successful postoperative alignment (+/-10Δ relative to target angle for exotropia, between 10Δ base out and 5Δ base in for esotropia). No intra/postoperative complications were reported (excluding residual strabismus) and outcomes were similar regardless of the type of cataract surgery performed. Mean operating time was less <1 hour. The authors acknowledged several limitations, including the retrospective design, small sample size, lack of a control group and short follow-up period. This study addresses a practical clinical dilemma, namely whether cataract and strabismus surgery should be performed separately or together. The findings suggest that combining procedures can reduce the number of operations and recovery periods without compromising outcomes of either surgery. This has clear benefits for both patients and healthcare services. Further larger prospective studies are needed.
Exploring postoperative outcomes of combined strabismus and cataract surgery in adults
Reviewed by Lauren Hepworth
Combined strabismus and cataract surgery in adults with longstanding horizontal strabismus and coexisting senile cataract.
CONTRIBUTOR
Lauren R Hepworth
University of Liverpool; Honorary Stroke Specialist Clinical Orthoptist, Northern Care Alliance NHS Foundation Trust; St Helen’s and Knowsley NHS Foundation Trust, UK.
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