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. 2021 Aug;25(4):207.e1-207.e5.
doi: 10.1016/j.jaapos.2021.03.009. Epub 2021 Jul 10.

The rate of superior oblique surgery in children and adolescents with Brown syndrome according to claims data

Hwan Heo  1 , Scott R Lambert  2
Affiliations

The rate of superior oblique surgery in children and adolescents with Brown syndrome according to claims data

Hwan Heo et al. J AAPOS. 2021 Aug.

Abstract

Purpose: To determine the rate of superior oblique surgery and how often it is combined with surgery on other extraocular muscles or associated with subsequent strabismus surgeries in children and adolescents with Brown syndrome.

Methods: This was a population-based retrospective cohort study using the Optum deidentified Clinformatics Data Mart Database (2004-2018) for patients ≤18 years of age diagnosed with Brown syndrome who underwent superior oblique surgery as their first strabismus surgery and had at least 6 months of continuous enrollment. We assessed sex, age, and the number of included patients by year and by age. Combined and subsequent strabismus surgeries were also investigated.

Results: Of 1,007 patients diagnosed with Brown syndrome, 115 (11.4%) underwent superior oblique surgery. The rate of superior oblique surgery was relatively constant between 2004 to 2018. The superior oblique surgery rate was highest in children ≤2 years of age with a decreasing rate as age increased. In 45 of 115 patients (39.1%), other extraocular muscles were operated on in addition to the superior oblique muscle. Of 88 patients who underwent superior oblique surgery without concurrent vertical muscle surgery as the first operation, 11 patients (12.5%) subsequently underwent an additional vertical muscle surgery because of newly developed or worsening vertical misalignment.

Conclusions: In this study cohort, superior oblique surgery was performed on 11.4% of children and adolescents with Brown syndrome. The number of patients with Brown syndrome and the rate of superior oblique surgery decreased as age increased to age 10 years.

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Figures

FIG 1.
FIG 1.
Flow diagram illustrating the path taken to identify patients diagnosed with Brown syndrome and who underwent superior oblique surgery
FIG 2.
FIG 2.
Superior oblique surgery rate (by year, 2004-2018) in patients ≤18 years of age newly diagnosed with Brown syndrome by year.
FIG 3.
FIG 3.
The superior oblique surgery rate (by age) in patients ≤18 years of age newly diagnosed with Brown syndrome.
See this image and copyright information in PMC

References

    1. Wilson ME, Eustis HS, Parks MM. Brown’s syndrome. Surv Ophthalmol 1989;34:153–72. - PubMed
    1. Suh DW, Oystreck DT, Hunter DG. Long-term results of an intraoperative adjustable superior oblique tendon suture spacer using nonabsorbable suture for Brown syndrome. Ophthalmology 2008;115:1800–804. - PubMed
    1. Wright KW. Brown’s syndrome: diagnosis and management. Trans Am Ophthalmol Soc 1999;97:1023–109. - PMC - PubMed
    1. Parks MM, Eustis HS. Simultaneous superior oblique tenotomy and inferior oblique recession in Brown’s syndrome. Ophthalmology 1987;94:1043–8. - PubMed
    1. Costenbader FD, Albert DG. Spontaneous regression of pseudoparalysis of the inferior oblique muscle. AMA Arch Ophthalmol 1958;59:607–8. - PubMed

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