Surgical Treatment of Strabismus in Children With Developmental Delay: A Review of the Literature and Results of Personal Experience.

PURPOSE: To review the current literature, to provide a foundation of knowledge on strabismus surgery in patients with developmental delay, and to present results from the authors' personal experience.

METHODS

The following terms were searched on PubMed: strabismus surgery, mental delay, developmental delay, Down syndrome, Angelman syndrome, cerebral palsy, hydrocephalus, Williams syndrome, fragile X syndrome, and fetal alcohol syndrome. Surgical outcomes were analyzed and discussed; only English articles were included. Medical records of 183 patients with developmental delay who underwent strabismus correction surgery from 2001 to 2020 were examined and discussed.

RESULTS

Articles were reviewed and analyzed, categorized based on the disease. The authors' experience included 183 patients with various diseases or syndromes: 44 Down syndrome, 40 fetal alcohol syndrome, 36 Williams syndrome, 9 fragile X syndrome, 12 Angelman syndrome, 11 Cohen syndrome, and 31 cerebral palsy. Surgical results at 3 and 18 months of follow-up were analyzed. Regarding esotropia surgery, 83.9% had a deviation of less than 8 prism diopters at 3 months and 53.8% at 18 months of follow-up. Hypocorrection was seen in 7.7% and 3.5% and hypercorrection was observed in 8.4% and 52.7% at 3 and 18 months, respectively. For exotropia, 60% had a deviation of less than 8 prism diopters at 3 months and 22.5% at 18 months. Hypocorrection occurred in 35% and 75%, whereas hypercorrection was found in 5% and 2.5%, respectively.

CONCLUSIONS

A higher prevalence of strabismus was found in these patients and the surgical outcomes were more difficult to predict. Patients with esotropia were more hypercorrected, whereas those with exotropia were more hyporcorrected. [J Pediatr Ophthalmol Strabismus. 2025;62(2):96-104.].