The Effect of Successful Surgical Alignment on Improvement of Binocular Vision in Adults with Childhood Strabismus

Purpose: To evaluate the effect of successful surgical alignment on improvement of binocular vision in adults with childhood strabismus Methods: In a prospective interventional study, consecutive patients with childhood-onset, comitant, horizontal and constant strabismus who had successful postoperative alignment were enrolled. Preoperative and postoperative binocular vision testing was performed using the Bagolini striated lenses and the Worths 4-dot test. Improvement of binocular vision was defined as conversion of suppression to fusion response in Bagolini test and conversion of suppression to fusion or monofixation response in Worth 4-dot test at three months after surgery. Results: A total of 34 patients (15 females and 19 males) were included. The mean age at the time of surgery was 26.08±10.53 years (range, 14-53 years). The mean angel of deviation was 40.29±14.35 prism diopter (range, 20-75 prism diopter). Binocular vision was improved in 20 of 34 patients (58.8%) in Bagolini test, also, binocular vision was improved in 20 of 34 patients (58.8%) in Worth 4-dot test. There was no significant correlation between duration of misalignment and sensory outcome (p=0.67). There was a statistically insignificant increase in improvement of binocular vision in exotropic group (65%) compared with esotropic group (50%) (p=0.48). Also, there was a statistically insignificant increase in improvement of binocular vision in nonamblyopic group (60.8%) compared with amblyopic group (54.5%) (p=0.5). The angel of preoperative deviation had no influence on improvement of binocular vision (p=0.08). Conclusion: Surgical realignment leads to improvements in binocular vision in 58.8% of adults with childhood strabismus regardless of the type and angle of preoperative deviation, duration of strabismus, or amblyopia.