Abstract:ABSTRACT Objective To analyze the demographic and clinical characteristics, as well as surgical patterns, of patients undergoing strabismus surgery at the People’s Hospital of Xinjiang Uygur Autonomous Region, and to provide reference for strabismus management in Northwest China. Methods Data on gender, ethnicity, age, type of strabismus, angle of deviation, and surgical procedures were retrospectively collected from 476 patients who underwent strabismus surgery between March 2023 and September 2024. Descriptive statistics and group comparisons (chi-square test, t-test, ANOVA with Bonferroni correction for multiple comparisons) were performed. Results Among 476 patients, the male-to-female ratio was nearly 1:1.03. Han Chinese accounted for 48.5%, while ethnic minorities constituted 51.5% (Uyghur being the largest, 35.9%). Exotropia was predominant (75.0%), with intermittent exotropia being the most common subtype (47.7% of all cases). Esotropia accounted for 23.5%, among which acute acquired comitant esotropia comprised 14.7% of esotropia cases. Vertical strabismus was present in 38.8% of patients. Surgery primarily involved horizontal rectus muscles, with lateral rectus surgery being the most performed (48.1%); the majority underwent two-muscle surgery (61.7%). Preoperative horizontal deviation was significantly smaller in unilateral surgery group (30.8±12.9 PD) than in bilateral surgery group (40.6±23.1 PD, P<0.001). Among A-V pattern strabismus, the oblique muscle weakening group had a larger AV angle than the horizontal muscle transposition group (P=0.036). Conclusion In Northwest China, intermittent exotropia is the most common type requiring surgery, frequently accompanied by vertical deviation. The relatively high proportion of acute acquired comitant esotropia suggests that lifestyle factors such as near work may influence the disease spectrum. Surgical strategy is mainly based on horizontal rectus muscles, with individualized design for cases with vertical components according to quantitative indicators.
