Peer-reviewed article
Outcomes of Strabismus Procedures in Children With Perinatal Brain Injury.
Zhou Y, Prakash E, Gaier ED, Heidary G, Gise R ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a medical study comparing surgical outcomes for strabismus (eye misalignment) in children with perinatal brain injury versus matched controls without brain injury. The study found that children with brain injury had lower success rates at 2-year follow-up, with more undercorrections despite comparable surgical dosing. The research is clinically focused on ophthalmological intervention outcomes rather than broader child well-being.
Key points
Limitations
This document addresses a specific medical condition and surgical procedure rather than child well-being more broadly. It provides no information about social, developmental, nutritional, educational, or protective aspects of child health.
Abstract
Purpose To compare long-term strabismus procedure success in children with perinatal intracranial injury and matched controls. Design Retrospective cohort study. Subjects We included 108 patients with strabismus (84 esotropia, 24 exotropia) and perinatal brain injury. Controls without brain injury were matched 1:1 by horizontal deviation type, age at intervention, and preoperative deviation magnitude. Methods Patients underwent incisional surgery, botulinum toxin injection, or botulinum toxin-augmented surgery with at least 2 years of follow-up. Main outcome measures Two-year motor success (horizontal deviation ≤10 prism diopters) and general motor-sensory success (motor success or fine stereopsis ≤100 arcseconds), without retreatment. Results At 3 to 6 months, success did not differ significantly (52.9% vs 67.3%; P = .098). At 2 years, motor success was lower in the brain-injury cohort overall (43.5% vs 65.7%; odds ratio [OR] = 0.31, 95% confidence interval [CI], 0.16-0.62; P = .0005) and in the esotropia subgroup (45.2% vs 66.7%; OR = 0.36, 95% CI, 0.17-0.74; P = .005). General motor-sensory success was also 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 with brain injury (P = .037), and failures were predominantly undercorrections. Among 60 matched esotropia pairs treated surgically, dosing was comparable (95.9% vs 96.6% of standard; P = .68). In the primary multiple-variable model, larger preoperative deviation was associated with lower general motor-sensory success in the combined cohort (OR = 0.963 per prism diopter, 95% CI, 0.934-0.994; P = .019) and esotropia subgroup (OR = 0.950, 95% CI, 0.912-0.989; P = .012). Botulinum toxin treatment was not independently associated with success in a sensitivity model (adjusted OR = 0.18; P = .126). Male sex was associated with motor failure in exotropia (OR = 0.03; P = .015). Conclusions Children with perinatal brain injury had lower long-term treatment success, predominantly from undercorrection, despite comparable surgical dosing. Larger preoperative deviation was associated with lower success, particularly in esotropia. These findings support tailored counseling and prospective surgical dosing studies.