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Volume 48, 1998, p. 6576

Clinical Characteristics of Adult Strabismus and Results of Surgical Treatment (Abstract)
Richard W. Hertle, M.D., F.A.C.S. David B. Granet, M.D.

Objective/Design: Strabismus is present in approximately 4% of the population with most forms becoming clinically evident in infancy and childhood. Adult strabismus varies in etiology, presentation, symptomatology, and response to treatment. This report is intended to prospectively characterize adults who required surgical correction of their strabismic deviation.


Methods: Beginning in 1991, a prospective computerized database was started which contained all clinical, laboratory, and surgical information on the adult ocular motility service at the Scheie Eye Institute and The Children's Hospital of Philadelphia (Philadelphia, PA). Demography, clinical characteristics, and surgical procedures with results were analyzed separately in adults with their strabismus beginning before visual maturation (BVM) (9 years of age) and after visual -maturation (AVM).


Results: A minimum of 6 months and average of 1.8 years follow up is reported on 263 procedures in 255 patients with an average age of 37 between January 1991 and January 1996. Sixty-two percent of patients had their strabismus onset BVM. Fifty one percent of BVM patients and 80% of AVM patients had incomitant deviations. Adjustable suture surgery was performed on 97% of all patients with 28% BVM and 57% of AVM patients having multiplanar surgery. Successful motor alignment was achieved in 85% of all patients after one surgical procedure. Sensory success was achieved in 81% of all AVM patients and 25% of all BVM patients.


Conclusions: Although treatment using adjustable suture surgery is effective, differences in results reflect the varied physiology regarding etiology, pathophysiology and symptomology. Classification into AVM and BVM groups will provide continued clarity for future studies.