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.