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Characteristics and differences of strabismus surgeries performed in private versus public settings: a national multicenter study

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Abstract

Purpose

To investigate and compare the demographics, diagnoses, and surgical procedure types of strabismus repair in public and private hospitals in Israel in order to highlight possible disparities between them.

Methods

Retrospective descriptive study included all strabismus surgeries in seven private hospitals, compared with two large public university-affiliated hospitals from June 2016 to June 2021. Electronic medical records were directly retrieved to produce an anonymized database.

Results

During the study period 2420 operations were performed. Patients who underwent strabismus surgery in public hospitals were older and had shorter procedures (p < 0.001 and p = 0.004, respectively). The median number of operated muscles and the prevalence of bilateral procedures were higher in private hospitals (p < 0.001 and p < 0.001, respectively). Surgery for common strabismus, especially esotropia, was more prevalent in private (p < 0.001), whereas surgery for vertical strabismus, cranial nerve palsies and complex syndromes were performed more often in public hospitals (p < 0.001, p = 0.008, and p < 0.001, respectively). Rectus recession and inferior oblique (IO) anteriorization were more predominant in private hospitals (p = 0.002 and p < 0.001, respectively), while recuts advancement and IO myectomies were more prevalent in public ones (p = 0.001 and p < 0.001, respectively). Reoperations were far more common in public hospitals (27.2% vs 6.2%, p < 0.0001). This was true across most age groups.

Conclusions

Candidates for strabismus surgery in private hospitals in Israel are often younger, with more common diagnoses, and are usually referred for simpler procedures.

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Authors and Affiliations

  1. Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

    Asaf Israeli

  2. Department of Academy and Research, Assuta Medical Center, Tel-Aviv, Israel

    Keren Hod

  3. Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel

    Eedy Mezer

Authors
  1. Asaf Israeli
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  2. Keren Hod
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  3. Eedy Mezer
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Contributions

AI conceptualized and designed the study, overviewed the data collection, statistical analysis, wrote the manuscript and was in charge of any required revisions. KH assisted with organization of the data and performed the statistical analysis. She also provided all tables. EM initiated the study, supervised all parts of the submission and critically reviewed and revised the manuscript for important professional and intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Asaf Israeli.

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Israeli, A., Hod, K. & Mezer, E. Characteristics and differences of strabismus surgeries performed in private versus public settings: a national multicenter study. Int Ophthalmol 43, 3247–3255 (2023). https://doi.org/10.1007/s10792-023-02725-y

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  • DOI: https://doi.org/10.1007/s10792-023-02725-y

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