RESUMEN
OBJETIVO: Analizar las cirugías de estrabismo y los resultados durante un año y medio en un hospital terciario. MATERIAL Y MÉTODOS: Estudio retrospectivo de pacientes operados de estrabismo. Se analizó: edad media, sexo, diagnóstico, diplopía, técnica y anestesia, suturas ajustables, resultados, re-intervenciones y tiempo de seguimiento desde la cirugía. Se consideró buen resultado una desviación horizontal < 10 dioptrías prismáticas (dp) y vertical < 5 dp, sin diplopía. RESULTADOS: Se operaron 153 casos, con una edad media de 43,14 ± 25,58 años (61,4% mujeres). El 74,5% eran ≥ 18 años (33,33% ≥ 60). El 51% tenían diplopía. La desviación más frecuente fue horizontal: 83,6%. El diagnóstico más frecuente fue la parálisis de los nervios craneales: 32% (VI nervio: 12,4%), los estrabismos restrictivos representaron un 7,2% y la esotropía asociada a la edad, un 6,5%. Se emplearon suturas ajustables en el 19,7% y anestesia tópica en el 65,4%. El 79,2% obtuvieron buenos resultados al final del seguimiento. Las re-intervenciones fueron el 25,5%. El tiempo medio de seguimiento fue de 11,87 meses ± 6,5. El sexo femenino (p = 0,012) y la cirugía de oblicuo superior (p = 0,017) se asociaron a un peor resultado. CONCLUSIÓN: La cirugía del estrabismo del adulto fue tres veces más frecuente que la de los niños. La tercera parte de los adultos que se operaron eran ≥ 60 años. Las parálisis fueron la patología más frecuente. Las suturas ajustables se emplearon en escaso número de pacientes. Se obtuvieron buenos resultados en la mayoría de los casos
OBJECTIVE: To analyze the strabismus surgeries and the outcomes during a year and a half in a tertiary hospital. MATERIAL AND METHODS: A retrospective study of patients who underwent strabismus surgery. The mean age, sex, diagnosis, diplopia, surgery, anesthesia, adjustable sutures, results, reoperations and follow up time from surgery were analyzed. A good outcome was considered when the final horizontal deviation was less than 10 prism diopters (pd) and the vertical deviation less than 5 pd without diplopia. RESULTS: A total of 153 cases were operated on, mean age: 43.14 ± 25.58 years (61.4%: women).74.5% of patients were ≥ 18 years (33.33% ≥ 60). Diplopia was present in 51% of patients. The most frequent deviation was horizontal: 83.6%. The most frequent diagnosis was cranial nerve palsies: 32% (VI nerve: 12.4%), restrictive strabismus: 7.2%, and the aged related distance esotropia: 6.5%. Adjustable sutures were used in 19.7% of cases and topical anesthesia in 65.4%. Good outcomes was present in 79.2% of cases at the end of follow-up. Reoperations were needed in 25.5%. Follow-up evolution time was 11.87 months ± 6.5. The sex female (P = .012) and the oblique superior surgery (P = .017) were associated with bad outcome. CONCLUSIÓN: The adult strabismus surgery was three times more frequent than the children strabismus surgery. The third of the adults that were operated on were ≥ 60 years. The cranial nerve palsies were the most frequent diagnosis. Adjustable sutures were rarely used. Good outcomes were obtained in most of the patients at the end of follow-up
Asunto(s)
Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Esotropía/diagnóstico , Esotropía/cirugía , Diplopía/diagnóstico , Diplopía/cirugía , Procedimientos Quirúrgicos Oftalmológicos/tendencias , Estudios Retrospectivos , Estrabismo/diagnóstico , Estrabismo/cirugía , Complicaciones Posoperatorias , Análisis Multivariante , Procedimientos Quirúrgicos Oftalmológicos/estadística & datos numéricos , Resultado del TratamientoRESUMEN
OBJECTIVE: To analyze the strabismus surgeries and the outcomes during a year and a half in a tertiary hospital. MATERIAL AND METHODS: A retrospective study of patients who underwent strabismus surgery. The mean age, sex, diagnosis, diplopia, surgery, anesthesia, adjustable sutures, results, reoperations and follow up time from surgery were analyzed. A good outcome was considered when the final horizontal deviation was less than 10prism diopters (pd) and the vertical deviation less than 5pd without diplopia. RESULTS: A total of 153 cases were operated on, mean age: 43.14 ±25.58years (61.4%: women). 74.5% of patients were ≥18years (33.33% ≥60). Diplopia was present in 51% of patients. The most frequent deviation was horizontal: 83.6%. The most frequent diagnosis was cranial nerve palsies: 32% (VI nerve: 12.4%), restrictive strabismus: 7.2%, and the aged related distance esotropia: 6.5%. Adjustable sutures were used in 19.7% of cases and topical anesthesia in 65.4%. Good outcomes was present in 79.2% of cases at the end of follow-up. Reoperations were needed in 25.5%. Follow-up evolution time was 11.87 months ±6.5. The sex female (P=.012) and the oblique superior surgery (P=.017) were associated with bad outcome. CONCLUSION: The adult strabismus surgery was three times more frequent than the children strabismus surgery. The third of the adults that were operated on were ≥60 years. The cranial nerve palsies were the most frequent diagnosis. Adjustable sutures were rarely used. Good outcomes were obtained in most of the patients at the end of follow-up.