Abstract
Objective: To identify the factors affecting surgical success in patients who underwent horizontal concomitant strabismus surgery.
 Materials and Methods: Medical records of 143 patients who underwent concomitant horizontal strabismus surgery and who were followed up at least 6 months at Ordu University, Faculty of Medicine, Department of Ophthalmology between January 2015 and December 2020 were reviewed retrospectively. Surgical success was defined as postoperative orthophoria or deviation angle of 10 prism diopters (PD) or less at 6 months after surgery.
 Results: 101 (70.63%) patients with esotropia and 42 (29.37%) patients with exotropia were operated. The mean follow-up period was 18.54 ± 17.51 months, the mean distance and near preoperative deviation were 46.94 ± 11.62 PD and 47.29 ± 11.81 PD, respectively. The surgical success was 83.92% in all patients, 87.13% in esotropic patients, and 76.19% in exotropic patients. Additional surgery was performed in 8 (5.59%) patients with >20 PD residual strabismus in the following year. Preoperative distance and near deviations were found to be significantly related with surgical success (p=0.020 and p=0.026). As the preoperative deviation decreases, the surgical success increases significantly. The deviation type, age at onset, age at the time of surgery, the interval between diagnosis and surgery, gender, or preoperative amblyopia were not significantly related to surgical success (p>0.05).
 Conclusion: The surgical success was found to be high following concomitant horizontal strabismus surgery. Since the preoperative deviation angle is the significant factor determining surgical success, preoperative evaluations should be done carefully. Patients and their parents should also be warned about the probability of additional surgery.
Highlights
The aim of the treatment in patients with strabismus is to prevent amblyopia, to achieve binocular vision, and to ensure normal visual development by ensuring the parallelism of the visual axes, especially in the younger age group
Since the preoperative deviation angle is the significant factor determining surgical success, preoperative evaluations should be done carefully. Patients and their parents should be warned about the probability of additional surgery
In a study conducted by reviewing the records of more than 30 million patients in the United States, the frequency of strabismus was found to be 2.75%, the rate of strabismus surgery within 4 years was 0.13% in those patients, and the need for re-surgery within 1 year was 6.72% [5]
Summary
The aim of the treatment in patients with strabismus is to prevent amblyopia, to achieve binocular vision, and to ensure normal visual development by ensuring the parallelism of the visual axes, especially in the younger age group. Strabismus is relatively uncommon in ophthalmology practice, but it has been shown that one out of every 20 strabismus patients requires surgery [5]. There are studies showing that the quality of life of patients with ocular misalignment is negatively affected due to functional and psychosocial aspects [1,6]. It is clear that appropriate optical corrections and, if necessary, surgical treatment are required in patients with squint. Identifying the factors affecting postsurgical success in patients who are scheduled for surgery due to ocular misalignment plays an important role in planning the surgery and increasing postsurgical success. This study aimed to evaluate the factors affecting surgical success in patients with horizontal concomitant strabismus
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