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Prognosis good for fusion after strabismus surgery in patients with brain injury
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SAN DIEGO — Patients with diplopia secondary to brain tumors typically have a good prognosis for fusion after successful strabismus surgery, a presenter said here.
However, vascular or traumatic brain lesions leading to prolonged coma or central fusional disruption may preclude fusion even after mechanically successful strabismus surgery that restores ocular alignment, Maria Carolina Otube, MD, said at the American Association for Pediatric Ophthalmology and Strabismus meeting.
"In strabismus secondary to severe head trauma or vascular lesions and coma, it is very important to counsel patients and discuss the possibility of permanent diplopia," she said.
Dr. Otube and colleagues conducted a retrospective analysis of 50 patients with a history of strabismus caused by brain injury: 24 with tumoral lesions, 14 with vascular lesions, 10 with severe trauma or motor vehicle accident and 2 with infection. Forty-one of the 50 patients presented with diplopia. In the study, 48 of 50 (96%) patients underwent surgery, and 39 of these 48 patients were free of diplopia after surgery. Diplopia persisted in 19% of patients who underwent surgery.
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