Cirugía de estrabismo en adultos: resultados motores y sensoriales / Strabismus surgery in adults: sensory and motor results

Objetivo: determinar los resultados quirúrgicos y la obtención de fusión y estereopsis en adultos operados de estrabismo adquirido y si el tiempo transcurrido entre la aparición de la desviación y la cirugía influyó en la obtención de fusión y estereopsis. Métodos: se realizó una investigación descriptiva, de corte longitudinal y prospectivo, en adultos operados de estrabismo adquirido, quienes acudieron a la consulta de Oftalmología Pediátrica y Estrabismo del Instituto Cubano de Oftalmología Ramón Pando Ferrer de enero a diciembre del año 2013. Se analizaron las variables edad, sexo, edad de inicio del estrabismo, tiempo de evolución, diagnóstico, sentido de la desviación, agudeza visual, síntomas y signos, alineamiento ocular, fusión y estereopsis posoperatoria. Resultados: las causas más frecuentes fueron la parálisis o paresias de músculos extraoculares y la exotropía, ambas con 37,7 por ciento. El 34 por ciento de los casos sobrepasaban los tres años de evolución. Se logró el alineamiento ocular y la fusión en el 73,6 por ciento, y se recuperó la estereopsis en el 52,8 por cientot. El 90,9 por ciento de los pacientes que estuvieron desviados menos de un año alcanzaron fusión y estereopsis. Conclusiones: la cirugía de estrabismo de adulto permite recuperar el alineamiento ocular, la fusión y la estereopsis, con más posibilidades de recuperación funcional cuando se realiza con menor tiempo de evolución(AU)

Objective: to describe the surgical results and the fusion and stereopsis achieved in adults operated on for acquired strabismus, and to determine whether the time elapsed from the emergence of deviation to the time of surgery had an effect on fusion and stereopsis. Methods: prospective, longitudinal and descriptive research conducted in adults operated on for acquired strabismus, who had been seen at the Pediatric Ophthalmology and Strabismus service of Ramón Pando Ferrer Cuban Institute of Ophthalmology from January to December 2013. The analyzed variables were age, sex, the age at the onset of strabismus, time of progression, diagnosis, deviation angle, visual acuity, symptoms and signs, eye alignment and postoperative fusion and stereopsis. Results: the most frequent causes were extra ocular muscle palsy or paresis and exotropia, both accounting for 37.7 percent of cases. Over three years of progression was observed in 34 percent of patients. Eye alignment and fusion occurred in 73.6 percent whereas stereopsis was recovered in 52.8 percent of patients. In the study group, 90.9 percent of patients with deviation angle for less than one year reached fusion and stereopsis. Conclusions: strabismus surgery in adults allows recovering eye alignment, fusion and stereopsis, and the possibilities of functional recovery increase when the time of progression of disease is shorter(AU)

Long Term Surgical Results after Early Surgery for Infantile Esotropia Before and After 1 year of Age

PURPOSE: To analyze the long term surgical results after early surgery for infantile esotropia before and after 1 year of age and to investigate postoperative eye alignments. METHODS: This retrospective study included 46 patients with infantile esotropia who underwent surgery before 2 years of age and were followed up for a minimum of 5 years. Subjects were divided into 2 groups: those who underwent surgery before 1 year of age (n=22, group 1), and the ones who underwent surgery between 1 year of age and 2 years of age (n=24, group 2). RESULTS: Long term postoperative alignment between two groups was not statistically significant. In postoperative stereopsis test, 11 patients (78.6%) of group 1 and 7 patients (41.2%) of group 2 had stereopsis and the patients of group 1 had more favorable stereoacuity than the patients of group 2. These differences were statistically significant, respectively (p=0.039). In postoperative eye alignment, patients of group 1 showed tendency to become exodeviated to esodeviated and patients of group 2 showed tendency to become esodeviated to exodeviated. These differences were statistically significant, respectively (p=0.023, p=0.042). CONCLUSIONS: To achieve better binocular function, early surgical alignment before 1 year of age is more recommended. Because early surgery before and after 1 year of age displays contradictory postoperative eye alignment, close follow up and careful consideration at reoperation is recommended.