Binocular vision outcomes following surgery for long-standing large angle exodeviation

Area of Science:

• Ophthalmology
• Neuroscience
• Vision Science

Background:

• Pre-operative sensorimotor testing aims to predict fusion potential for strabismus surgery.
• Recovery of binocular vision after strabismus repair is inversely related to the duration of misalignment.
• This study investigates binocular vision outcomes in patients with long-standing, large-angle constant exotropia.

Purpose of the Study:

• To evaluate binocular vision outcomes after surgical correction of long-standing, large-angle constant exotropia.
• To assess the impact of pre-operative sensorimotor findings on post-operative binocular vision.
• To determine if poor pre-operative sensory predictions preclude successful surgical outcomes.

Main Methods:

• Recruited patients with constant exotropia (>35Δ) present for ≥20 years.
• Classified patients into three groups based on pre-operative sensorimotor results: fusion (Group A), suppression (Group B), and paradoxical diplopia (Group C).
• Analyzed post-operative binocular vision recovery in each group.

Main Results:

• Twenty patients were included: 11 in Group A, 5 in Group B, and 4 in Group C.
• Post-operative binocular vision recovery rates were 100% for Group A, 80% for Group B, and 50% for Group C.
• Surgical realignment improved binocular vision in the majority of patients.

Conclusions:

• Surgical correction of strabismus can significantly improve binocular vision, even in cases of long-standing, large deviations.
• Pre-operative paradoxical diplopia or dense suppression does not necessarily prevent a favorable sensory outcome.
• These findings support surgical intervention for selected patients with chronic exotropia.