Risk factors and management for postoperative complications in strabismus surgery
Reviewed by Su Young

This retrospective cohort study examined 1273 patients, comprising 1035 cases of exotropia and 238 cases of esotropia, with a minimum 18-month follow-up after strabismus surgery. Baseline demographics, age at surgery, pre / postoperative visual acuity, and deviation were included. Complications were categorised into surgical site issues (infection, scarring, cyst, granuloma, ischaemia) and strabismus-related problems (recurrence, diplopia). For surgical site complications, the incidence of infection, pyogenic granuloma, and anterior segment ischaemia was comparable between the exotropia and esotropia groups, indicating no significant difference. However, the esotropia group exhibited a higher risk of conjunctival inclusion cyst and conjunctival scar compared to the exotropia group. Specifically, incidences of 5.0% vs. 2.2% for inclusion cysts and 6.3% vs. 1.3% for conjunctival scars were observed. On recurrence of strabismus, the study found no significant difference in the early recurrence rates between exotropia (10.0%) and esotropia (10.5%) groups. However, older age and poor initial visual acuity were identified as risk factors for early recurrence. Notably, the esotropia group exhibited a higher risk of persistent diplopia (4.2%) compared to the exotropia group (2.0%). In conclusion, the authors hope this study will guide clinicians in risk assessment and tailored management strategies when planning horizontal strabismus surgery.

Incidence, risk factors and management of postoperative complications in horizontal strabismus surgery.
Huang YT, Lin SC, Huang LY, et al.
SEMINARS IN OPHTHALMOLOGY
2024;39(2):143–9.