Quentin Colas1, Jean Capsec2, Sophie Arsène1, Pierre Jean Pisella1, Leslie Grammatico-Guillon2, Raoul K Khanna3,4. 1. Department of Ophthalmology, Bretonneau University Hospital, 2 Boulevard Tonnellé, 37044, Tours, France. 2. Regional Unit of Epidemiology (EpiDcliC), Service of Medical Information, Epidemiology and Medical Economy, Teaching Hospital of Tours, Medical School, University of Tours, Tours, France. 3. Department of Ophthalmology, Bretonneau University Hospital, 2 Boulevard Tonnellé, 37044, Tours, France. raoul.khanna@univ-tours.fr. 4. UMR 1253, iBrain, Tours, Centre-Val de Loire, Tours, France. raoul.khanna@univ-tours.fr.
Abstract
PURPOSE: To describe the types of strabismus operated on, the surgical procedures performed, and the 2-year reoperation rate in France. METHODS: Entire population 5-year cross-sectional analysis of a national medico-administrative database in France between January 2013 and December 2017 included all patients who underwent a first strabismus surgery, with a 2-year follow-up. Patient identification was based on the diagnostic codes of the 10th International Classification of Diseases and surgical procedures on the codes of the Common Classification of Medical Acts. A subgroup analysis comparing non-paralytic and paralytic strabismus was performed. RESULTS: Among the 56,654 patients included (women: 50.8%), 26,892 (47.5%) patients were under 10 years old. Overall, 52,711 (93%) were diagnosed with non-paralytic strabismus and 3,943 (7%) with paralytic strabismus. Among the non-paralytics, the most frequent diagnosis was esotropia (21,282, 37.6%), followed by exotropia (14,392, 25.4%) and vertical strabismus (2,017, 3.6%). Among the paralytics, fourth cranial nerve palsy (1,499, 2.6%) was more frequent than sixth cranial nerve palsy (691, 1.2%) and third cranial nerve palsy (431, 0.8%). The 2-year reoperation rate was 7.7% (4,362 patients), the lowest for non-paralytic (7.4%) and the highest for paralytic (11.4%). CONCLUSION: This first French population-based study about strabismus will contribute to the evaluation of practices at a national level and permit comparisons between countries. Although the 2-year reoperation rate was found to be 1 out of 13 patients, it should be interpreted with caution. Long-term follow-up is still warranted due to considerable variability of the type and severity of strabismus as well as surgical practices.
PURPOSE: To describe the types of strabismus operated on, the surgical procedures performed, and the 2-year reoperation rate in France. METHODS: Entire population 5-year cross-sectional analysis of a national medico-administrative database in France between January 2013 and December 2017 included all patients who underwent a first strabismus surgery, with a 2-year follow-up. Patient identification was based on the diagnostic codes of the 10th International Classification of Diseases and surgical procedures on the codes of the Common Classification of Medical Acts. A subgroup analysis comparing non-paralytic and paralytic strabismus was performed. RESULTS: Among the 56,654 patients included (women: 50.8%), 26,892 (47.5%) patients were under 10 years old. Overall, 52,711 (93%) were diagnosed with non-paralytic strabismus and 3,943 (7%) with paralytic strabismus. Among the non-paralytics, the most frequent diagnosis was esotropia (21,282, 37.6%), followed by exotropia (14,392, 25.4%) and vertical strabismus (2,017, 3.6%). Among the paralytics, fourth cranial nerve palsy (1,499, 2.6%) was more frequent than sixth cranial nerve palsy (691, 1.2%) and third cranial nerve palsy (431, 0.8%). The 2-year reoperation rate was 7.7% (4,362 patients), the lowest for non-paralytic (7.4%) and the highest for paralytic (11.4%). CONCLUSION: This first French population-based study about strabismus will contribute to the evaluation of practices at a national level and permit comparisons between countries. Although the 2-year reoperation rate was found to be 1 out of 13 patients, it should be interpreted with caution. Long-term follow-up is still warranted due to considerable variability of the type and severity of strabismus as well as surgical practices.
Authors: Alain M Bron; Anne-Sophie Mariet; Eric Benzenine; Louis Arnould; Vincent Daien; Jean François Korobelnik; Catherine Quantin; Catherine Creuzot-Garcher Journal: Br J Ophthalmol Date: 2017-03-14 Impact factor: 4.638
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