Review of outcome of horizontal childhood strabismus surgery at Kenyatta National Hospital and Kikuyu Eye Unit

Abstract

Background: With early management of strabismus, improved visual acuity and better cosmetic outcomes can be achieved. Strabismus surgery aims to improve the cosmetic appearance of the eyes and eventually reduce the negative psycho-social impact, possibly restore Binocular Single Vision (BSV) and centralize or expand the field of BSV hence this study is of importance to determine whether we are achieving the aims of surgery.
Objectives: The aim of this study was to determine the outcome of horizontal childhood strabismus surgery at Kenyatta National Hospital (KNH) and Kikuyu Eye Unit (KEU).
Methods: A retrospective case series was carried out targeting children who underwent strabismus surgery.
Results: A total of 199 children (0 – 15 years) who had corrective strabismus surgery from June 2008 to June 2013, of whom 122/199 (61.3%) completed the 2-3 month follow-up. Forty one out of ninety (45.6%) cases of esotropia and 19/32 (59.4%) cases of exotropia had a good outcome, while the poor outcome was 15/90 (16.7%) and 2/32 (6.3%), respectively. Bilateral medial rectus recession for esotropia had 12/34 (35.3%) good outcome and 6/34 (17.6%) poor outcome, while recess-resect procedure for esotropia had 27/53 (50.9%) good and 9/53 (17%) poor outcome. Bilateral lateral rectus recession for exotropia had 4/9 (44.4%) good and 1/9 (11.1%) poor outcome, while for recess-resect procedure for exotropia had 15/23 (65.2%) good and 1/23 (4.3%) poor outcome.
Conclusions: The most common type of paediatric strabismus was esotropia. Most common surgery
performed was a recess-resect procedure for all types of tropia. Surgical success rate was generally good.