COECSA, Journal, Ophthalmology
Review of outcome of horizontal childhood strabismus surgery at Kenyatta National Hospital and Kikuyu Eye Unit
Download PDF Article

Keywords

Amblyopia
Binocular single vision
Strabismus
Surgical outcome
Refraction

How to Cite

Fazal AF, Kimani K, Nyamori J, Mundia D. (2023). Review of outcome of horizontal childhood strabismus surgery at Kenyatta National Hospital and Kikuyu Eye Unit. The Journal of Ophthalmology of Eastern, Central and Southern Africa, 15(01). Retrieved from https://joecsa.coecsa.org/index.php/joecsa/article/view/292

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.

Download PDF Article

References

Yanoff M, Duker J. Ophthalmology. 2nd ed. St

Louis, USA: Mosb; 2004. 978–98 p.

Maconachie G, Gottlob I, McLean R. Risk

factors and genetics in common comitant

strabismus: a systematic review of the literature.

JAMA Ophthalmol. 2013; 131(9):1179–86.

Garcia C, Sousa AB, Mendonca MBD.

Prevalence of strabismus among students in

Natal/ RN-Brazil. Arq bras oftalmol. 2004;

(5):791–794.

Bicas HE. Visäo binocular e estrabismo. Arq

bras oftalmol. 1987; 50(1):36–41.

World Health Organization (WHO).

Preventing blindness in children [Internet].

WHO/IAPB Scientific Meeting,. WHO;

Available from: http://apps.who.int/iris/

bitstream/10665/66663/1/WHO_PBL_00.77.pdf

Simons K. Amblyopia characterization,

treatment, and prophylaxis. Surv Ophthalmol.

; 50(2):123–66.

Woodruff G, Hiscox F, Thompson J. The

presentation of children with amblyopia. Eye.

; 8((Pt 6)):623–626.

Agrawal S, Singh V, Gupta S., Agrawal S.

Evaluating a new surgical dosage calculation

method for esotropia. Oman J Ophthalmol.

; 6(3):165–169.

Gogate P., Rishikeshi N, Taras S, Aghor M,

Deshpande M. Clinical audit of horizontal

strabismus surgery in children in Maharashtra

India. Strabismus. 2010; 18(1):13-17.

Mittal S, Maitreya A, Dhasmana R. Clinical

profile of refractive errors in children in a

tertiary care hospital of Northern India. Int J

Comm Med Publ Health. 2016; 3(5):1189–94.

Yamamah G, Talaat Abdul Alim A, Mostafa Y,

Ahmed R, Mahmoud A. Prevalence of visual

impairment and refractive errors in children

of South Sinai, Egypt. Ophthalmic Epidemiol.

; 22(4):246–252.

Mehari Z. Pattern of childhood ocular morbidity

in rural eye hospital, Central Ethiopia. BMC

Ophthalmol. 2014; 14(1):50.

Mahmudi E, Mema V, Burda N, Selimi B,

Zhugli S. Incidence of the refractive errors in

children 3 to 9 years of age, in the city of Tetovo,

Macedonia. J Acute Dis. 2013; 2(1):52–55.

Mtanda A. Cyclic esotropia – A case report and

review of the literature. East Afr J Ophthamol.

; 45–47.

Maruo T, Kubota N, Sakaue T, Usui C.

Intermittent exotropia surgery in children: long

term outcome regarding changes in binocular

alignment. A study of 666 cases. Binocul Vis

Strabismus Q. 2001; 16:265–270.

Kushner B. Selective surgery for intermittent

exotropia based on distance/near differences.

Arch Ophthalmol. 1998; 116:324–328.

Jeoung J, Lee M, Hwang J. Bilateral lateral

rectus recession vs unilateral recess-resect

procedure for exotropia with a dominant eye –

Reply. Am J Ophthalmol. 2006; 142:708–709.

Keenan J, Willshaw H. The outcome of

strabismus surgery in childhood exotropia. Eye.

; 8(6):632–637.

Keenan J, Willshaw H. Outcome of strabismus

surgery in congenital esotropia. Br J Ophthalmol.

; 76(6):342-345.

Mvogo C., Bella A., Ellong A, Didier O, Eballe

A., Tambi F. Surgical management of primary

exotropia in Cameroon. Clin Ophthalmol

(Auckland, NZ). 2007; 1(4):471.

Jeong G, Roh Y. Complications on strabismus

surgery. J Korean Ophthalmol Soc. 1988;

(4):619–623.

Espinoza G, Lueder G. Conjunctival pyogenic

granulomas after strabismus surgery.

Ophthalmology. 2005; 112(7):1283–86.

Downloads

Download data is not yet available.