Strabismus development after pediatric cataract surgery associated with age at surgery, intraocular lens implantation, and visual acuity outcome

Abstract

ABSTRACT Purpose Approximately half of the children operated on for cataracts develop strabismus. We determined what factors predict its development. Methods In a retrospective, cross-sectional study, children who underwent cataract surgery before age 5 between 2010 and 2017 in a tertiary center in Brazil were identified from medical records. Subsequently, patients were invited for an ophthalmological examination to assess visual acuity, refraction, and strabismus (constant or intermittent heterotropy of any magnitude). In addition, age at surgery, cataract laterality, intraocular lens implantation, surgical complications, nystagmus, anisometropia, and elapsed time between surgery and the present examination were assessed using logistic regression. Results Surgery was performed in 74 eyes of 46 patients (21 males). The median age at surgery was 6.4 (3.7–29.6) months, and the interval between surgery and this examination was 32.5 (18.0–53.0) months. Strabismus was present in 33 (72%) patients, 35% had esotropia and 33% exotropia. One patient had strabismus surgery before the examination. Age at surgery (OR 0.95; p-value .018), IOL implantation (OR 0.08; p-value .027), and current visual acuity on the worse eye (OR 1.16; p-value .036) were associated with strabismus. Conclusions Strabismus development after pediatric cataract surgery is associated with age at surgery, intraocular lens implantation, and visual-acuity outcomes of the worse eye.