Outcomes of Strabismus Procedures in Children with Perinatal Brain Injury.
Children with perinatal brain injury had lower long-term strabismus treatment motor success.
Outcomes of Strabismus Procedures in Children with Perinatal Brain Injury.
To evaluate the long-term success rates of strabismus procedures in children with a history of perinatal intracranial injuries compared to matched controls.
Underwent incisional surgery, botulinum toxin injection, or botulinum toxin-augmented surgery with at least two years of follow-up.
Perinatal brain injury was associated with lower odds of long-term strabismus motor success
At 3-6 months, success did not differ significantly (52.9% vs 67.3%; P=.098).
General motor-sensory success was likewise lower overall (47.2% vs 69.4%; OR=0.33, 95% CI, 0.17-0.64; P=.0007) and in esotropia (47.6% vs 70.2%; OR=0.34, 95% CI, 0.17-0.71; P=.0034).
Postoperative drift was greater in the brain-injury cohort (P=.037), and failures were predominantly under-corrections.
Among 60 matched esotropia pairs undergoing incisional surgery alone, surgical dosing was comparable (95.9% vs 96.6% of standard; P=.68).
Children with perinatal brain injury had lower long-term strabismus treatment success, predominantly from undercorrection, despite comparable normalized surgical dosing.
Larger preoperative deviation was associated with lower success, particularly among patients with esotropia.
These findings support tailored preoperative counseling regarding secondary interventions and warrant prospective studies evaluating adjusted treatment dosing in this population.