{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T07:06:24Z","timestamp":1784790384392,"version":"3.55.0"},"reference-count":17,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: To evaluate the long-term outcomes of strabismus treatment in children with cerebral palsy (CP) and to investigate factors associated with postoperative alignment success and the development of consecutive strabismus. Methods: The retrospective, single-center study included 73 children with CP and strabismus who were followed from January 2015 to December 2024. Demographic characteristics, ophthalmological findings, treatment methods, and postoperative outcomes were assessed. Ocular deviation was measured through prism and alternate cover testing or a modified Krimsky test, and surgical success was defined as a final deviation of \u226410 prism diopters (PD). Patients were assessed at the patient level. Comparisons between exotropic and esotropic patients and between patients who had consecutive exotropia and those who had successful alignment were made using appropriate statistical tests. Results: Study participants included 55 patients with esotropia (75.3%) and 18 patients with exotropia (24.7%). The mean follow-up period was 32.6 \u00b1 7.18 months. A successful ocular alignment was achieved in 32 of 46 patients (69.6%) with esotropia and in 10 of 17 patients (58.8%) with exotropia following surgical treatment and\/or BTA. Consecutive exotropia developed exclusively in patients initially treated for esotropia (39.1% vs. 0%, p = 0.001). Patients with consecutive exotropia underwent surgery at a younger age and had larger preoperative deviation angles than those who had successful alignment, but these differences were not statistically significant. Conclusions: Strabismus treatment provides satisfactory long-term motor alignment in many children with cerebral palsy. However, consecutive exotropia following esotropia surgery remains a common postoperative condition and is the principal source of alignment instability in this population. Younger surgical age and larger preoperative deviations were more common among patients with consecutive exotropia, but no statistically significant associations between the evaluated clinical variables and consecutive exotropia were identified in the exploratory univariate analyses.<\/jats:p>","DOI":"10.3390\/children13080974","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T06:11:42Z","timestamp":1784787102000},"page":"974","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Outcomes of Strabismus Surgery in Children with Cerebral Palsy: Focus on Consecutive Exotropia"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9519-8715","authenticated-orcid":false,"given":"Ceren","family":"G\u00fcrez","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Clinic, Beyoglu Eye Training and Research Hospital, Health of Sciences University, 34437 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahid","family":"H\u00fcseyinhan","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Clinic, Beyoglu Eye Training and Research Hospital, Health of Sciences University, 34437 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1469-8749.2007.tb12609.x","article-title":"Definition and classification of cerebral palsy: A historical perspective","volume":"109","author":"Morris","year":"2007","journal-title":"Dev. Med. Child Neurol. Suppl."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1080\/09286586.2024.2331537","article-title":"Prevalence and Types of Strabismus in Cerebral Palsy: A Global and Historical Perspective Based on a Systematic Review and Meta-Analysis","volume":"32","author":"Herron","year":"2025","journal-title":"Ophthalmic Epidemiol."},{"key":"ref_3","first-page":"204","article-title":"Ocular disorders in children with spastic subtype of cerebral palsy","volume":"6","author":"Ozturk","year":"2013","journal-title":"Int. J. Ophthalmol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Ye, H., Liu, Q., Zhan, Q., Zhang, Y., Du, X., Zhang, X., Di, Y., and Qiao, T. (2022). Surgical outcomes and observation\u2028in exotropia cerebral palsy children with cortical visual impairment. BMC Ophthalmol., 22.","DOI":"10.1186\/s12886-022-02581-x"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2885","DOI":"10.1167\/iovs.09-4670","article-title":"Profile of refractive errors in cerebral palsy: Impact of severity of motor impairment (GMFCS) and CP subtype on refractive outcome","volume":"51","author":"Saunders","year":"2010","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.jaapos.2005.11.013","article-title":"Bilateral medial rectus muscle recession: Results in children with developmental delay compared with normally developed children","volume":"10","author":"Spierer","year":"2006","journal-title":"J. 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Ophthalmol."},{"key":"ref_17","first-page":"e71271","article-title":"Dose-Effect Relationship of Botulinum Toxin Type A in the Management of Strabismus: A Review","volume":"16","author":"Alhejaili","year":"2024","journal-title":"Cureus"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/974\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T06:27:21Z","timestamp":1784788041000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/974"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,23]]},"references-count":17,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["children13080974"],"URL":"https:\/\/doi.org\/10.3390\/children13080974","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,23]]}}}