Strabismus is a potential complication of pediatric cataract extraction that causes difficulty achieving binocular vision. Photo: B. Navez/Wikicommons. Click image to enlarge.

About 10% of patients who have pediatric cataract extraction will need strabismus surgery within five years, according to a paper recently published in Ophthalmology Science that examined a large cohort using claims data to evaluate associations and risk factors.

The researchers retrospectively analyzed claims from two US insurance databases of patients ≤18 years old who underwent cataract surgery and had no history of strabismus. They found that 4.7% (271/5,822) of children included in the study had strabismus surgery, with a 9.6% cumulative incidence of strabismus surgery within five years.

Undergoing strabismus surgery was significantly associated with the following:

• Younger age at the time of cataract surgery
• Female sex
• History of persistent fetal vasculature
• History of nystagmus
• Pre-existing strabismus diagnosis
• Less risk of IOL placement

Though the estimated cumulative incidence for strabismus surgery after cataract surgery was lower than estimates previously described, the researchers noted that their numbers were comparable when the data was stratified by age and pre-existing strabismus diagnosis. They concluded in their paper that “future efforts toward screening would be particularly beneficial in these patients.”

Hwang B, Oke I, Lambert SR. Risk factors for strabismus surgery after pediatric cataract surgery in the United States. Ophthalmol Science. January 5, 2023. [Epub ahead of print].