Strabismus surgery for Medicare-aged patients: more than a decade of insights

Abstract

The psychosocial and functional impact of strabismus among the elderly is increasingly important as life expectancy increases and factors that enhance the quality of life become more significant. The purpose of this study was to characterize the demographics, presenting complaints, health status, underlying etiology, and outcomes of strabismus surgery in three age cohorts of Medicare-aged patients. The medical records of patients at least 65years of age who underwent strabismus surgery between 2004 and 2015 in a university-based strabismus practice were reviewed retrospectively. A total of 110 patients were identified and divided into three age cohorts for analysis: young-old (age 65-74), middle-old (age 75-84), and old-old (age 85+). At least 75% of patients in all cohorts cited diplopia as their chief complaint (P=0.87). There was no difference in sex distribution, type of deviation, underlying etiology, or preoperative American Society of Anesthesiologists physical status classification scores between the cohorts (P=0.68, P=0.53, P=0.71, P=0.93, resp.). By the 6- to 8-week postoperative visit, 63% of all patients reported complete resolution of their presenting chief complaint, 23% reported some improvement, and 11% reported no improvement, with no difference between the cohorts (P=0.12). Given the functional and psychosocial impact of strabismus in the elderly, this study lends support to consideration of surgery as a viable option to successfully treat strabismus among the oldest age cohorts.