Binocularity following surgical correction of strabismus in adults

Purpose: This is a retrospective study to determine the pre- and postoperative binocular status of adults who have undergone surgical correction of strabismus. Methods: A list of all consecutive adult patients who underwent surgery for strabismus between June 1990 and December 2001 (surgery by MBM) was compiled and their medical charts were reviewed. Patients who had at least 6 weeks postoperative follow-up were included if their charts were available for review and if information on binocularity was recorded. Binocularity was measured by the Titmus stereo test (Stereo Optical Co., Inc., Chicago), and/or the Worth 4-Dot test for distance (Scioto Medical Products, Powell, OH [discontinued]), and/or the Worth 4-Dot near test (Gulden Ophthalmics, Inc., Elkin Park, PA). Improvements or decreases in stereo acuity were noted 6 weeks postoperatively and at the final office visit. Prism management was incorporated pre- and/or postoperatively in some of our patients. A total of 112 patients underwent surgery for strabismus. Of these, 72 patients, aged 16 to 80 years, were included; 24 were excluded as their charts did not contain any information on stereo acuity 6 weeks postoperatively or were lost to follow-up after surgery, and 16 were excluded because their charts were unavailable from storage. Results: The mean follow-up for the study patients was 16.5 months (range 6 weeks to 79 months). Overall, 30 of the 72 patients improved in binocular function (42%), 38 remained the same (53%), and 4 decreased (5%). If you exclude those patients with 40 sec of stereo acuity preoperatively whose stereopsis, by definition, could not improve further, and look only at the 59 surgical patients who could improve, then 51% improved. A variety of surgical procedures was performed, the most common being a bilateral medial rectus recession. Eleven patients required a second surgical procedure and two required a third surgical procedure. Conclusion: The benefits of surgical correction of strabismus in adults include improvement in binocular function as seen in 51% of the patients in the study.