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Strabismus outcomes after surgery: the nationwide SOS France study

  • Neurophthalmology
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

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.

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Abbreviations

CCAM:

Common Classification of Medical Acts

ICD-10:

10Th edition of the International Classification of Diseases

PMSI:

Programme de Médicalisation des Systèmes d’Information

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Acknowledgements

The English in this manuscript has been checked by A.D.T. International - L'Agence de Traduction.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Bretonneau University Hospital, 2 Boulevard Tonnellé, 37044, Tours, France

    Quentin Colas, Sophie Arsène, Pierre Jean Pisella & Raoul K. Khanna

  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

    Jean Capsec & Leslie Grammatico-Guillon

  3. UMR 1253, iBrain, Tours, Centre-Val de Loire, Tours, France

    Raoul K. Khanna

Authors
  1. Quentin Colas
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  2. Jean Capsec
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  3. Sophie Arsène
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  4. Pierre Jean Pisella
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  5. Leslie Grammatico-Guillon
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  6. Raoul K. Khanna
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Contributions

QC, JC, SA, PJP, LGG, and RKK were involved in drafting the article or revising it critically for important intellectual content, and all authors approved the final version to be published. RKK had full access to all of the data in the study and takes responsibility for the integrity and the accuracy of the data.

Corresponding author

Correspondence to Raoul K. Khanna.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The local Ethics Committee of the University Hospital of Tours approved this study. No nominative, sensitive, or personal data on patients were collected. Our study involves the reuse of already recorded and anonymized data. The study falls within the scope of the French reference methodology MR-005 according to 2016–41 law dated January 26th, 2016, on the modernization of the French health system, which requires neither information nor non-opposition of the included individuals. Access to linked anonymous file in the PMSI databases was approved by the French National Commission for Data Protection and Liberties (CNIL MR-005 number 3014040220).

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The authors declare no competing interests.

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Colas, Q., Capsec, J., Arsène, S. et al. Strabismus outcomes after surgery: the nationwide SOS France study. Graefes Arch Clin Exp Ophthalmol 260, 2037–2043 (2022). https://doi.org/10.1007/s00417-021-05541-1

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  • DOI: https://doi.org/10.1007/s00417-021-05541-1

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