Abstract
Purpose :
Limited information has been published describing reoperation rates for various strabismus surgeries in relation to age at first surgery. We performed a retrospective, observational clinical study to analyze reoperation rates compared to type of strabismus, age at first surgery, and geographic location within South Carolina and to determine factors associated with repeat strabismus surgery.
Methods :
We analyzed 25 years of longitudinal data from the South Carolina Revenue and Fiscal Affairs Office (RFAO). The inclusion criteria for the study were: (1) any admission for procedure with CPT codes 67311, 67312, 67314 or 67316 between January 1, 1996 and December 31, 2016, and (2) patient age <18 years during the time of admission for first surgery. If a second surgery was done, surgery data up to December 31, 2020 was obtained and included in analysis. Patients were categorized into 5 age groups: <2, 2 to <4, 4 to <6, 6 to <10, or 10 to <18 years old. Strabismus types were grouped as pure esotropia, esotropia plus vertical misalignment, pure exotropia, exotropia plus vertical misalignment, vertical misalignment alone, superior oblique palsy, restrictive, paretic, or other. A logistic regression model was constructed using repeat surgery as the outcome and using age and strabismus type as predictors.
Results :
A total of 9237 unique patients were identified; 1833 (19.8%) had repeat surgeries captured within the RFAO database, with follow-up time ranging from 4 to 25 years depending on the date of initial surgery. Increasing age was correlated with a decreasing reoperation rate.
For all types of strabismus, reoperation was higher in the <2 years age group compared to ages 2 to <4 years (OR 0.66), ages 4 to <6 years (OR 0.48), 6 to <10 years (OR 0.34), 10 to <18 years (OR 0.24, all P <0.001). The strabismus type with the greatest number of index cases was other (n=3901, 42.2%), followed by pure exotropia (n=2496, 27.0%) and pure esotropia (n=1760, 19.0%).
Conclusions :
Across all types of strabismic surgeries, patients operated on at a younger age require a higher rate of reoperation.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.