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Review of surgical treatment for strabismus targeting older adults over the past 20 years Masami Yamashita 1 , Miwa Komori 1 , Takumi Ariya 1 , Akari Arakawa 1 , Masakazu Takayama 1 , Akiko Hikoya 1 , Yoshihiro Hotta 1 , Miho Sato 1 1Department Ophthalmology, Hamamatsu University School of Medicine pp.736-741
Published Date 2025/6/15
DOI https://doi.org/10.11477/mf.037055790790060736
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Abstract Purpose:To characterize older adults who underwent strabismus surgery at Hamamatsu University Hospital and the changes observed over the past 20 years.

Participants and Methods:Patients aged ≥65 years who underwent strabismus surgery at our hospital between 2003 and 2023 were extracted at 5-year intervals. Data regarding age, sex, chief complaints, manifestations of strabismus, pre-operative angle of deviation at a far distance, and type of anesthesia were retrospectively collected from medical records. The years 2003, 2008, and 2013 were defined as the earlier period, whereas the years 2018 and 2023 were defined as later period. Statistical analyses were conducted using the Mann-Whitney U test, chi-square test and test of equal or given proportions.

Results:The number of patients aged ≥65 years who underwent strabismus surgery increased from 8/86 patients(9.3%)in 2003 to 18/175(10.3%), 18/146(12.3%), 27/181(14.9%), and 52/292(17.8%)in 2008, 2013, 2018, and 2023, respectively. Exotropia, esotropia, and vertical/torsional strabismus accounted for 40.9%, 27.3%, and 15.9% of cases, respectively, in the earlier period, and 44.3%, 25.3%, and 22.8%, respectively, in the later period. The mean pre-operative angle of deviation at far distance among the patients with esotropia was 55.4 PD and 31.2 PD in the earlier and later periods, respectively, indicating a significant decrease(p=0.02). Diplopia was the chief complaint in 50% and 71% of patients with esotropia and patients with vertical/torsional strabismus, respectively, in the earlier period. This percentage increased to 80% and 89%, respectively, in the later period(p<0.05).

Conclusion:The proportion of older patients undergoing strabismus surgery has increased over the past 20 years. The increase in the number of patients undergoing surgery to improve diplopia, even for small-angle strabismus, emphasizes the requirement for developing more advanced treatment strategies for older individuals with strabismus.


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電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

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