Session: Poster session C

Changing age spectrum in strabismus surgery

Introduction: The proportion of children undergoing strabismus surgery appeared decreasing. To verify that, we analyzed the age of patients who received extraocular muscle (EOM) surgery.

Methods: Data of patients were reviewed who underwent EOM surgery at the University Eye Hospital Giessen between 1991 and 2019 and compared numbers of operations in decadal age groups to the German population in the respective period. In addition, we evaluated indications of surgery. The data pool comprised > 25,000 surgeries including > 60,000 muscles operated.

Results: In comparison to 1991, in 2019 the proportion of children aged ≤ 10 years had decreased from 50.2% to 31.8%, corresponding to a relative decrease of more than one third. The proportion of patients aged > 50 years had increased from 6.5% to 22.5%, i.e., by factor > 3, while the population ≤ 10 years in 2019 was only 13% smaller than in 1991 and the population aged > 50 years had increased by not more than 37%. The major reason of the decreasing proportion of children was a 53% reduction in surgeries for esotropia. We found no apparent changes in the 2nd to 5th decades.

Conclusion: The lower proportion of children receiving EOM surgery appears to indicate improvement in vision screening during the past 4 decades. The increasing proportion of elder patients may result from better information on potential therapy and increased incidence of acquired strabismus with corresponding complaints. The demographic shift played a secondary role. Due to demography, further increase in demand of EOM surgery is likely.