Improvement of stereopsis following strabismus surgery in adults: a retrospective analysis

Adults who undergo strabismus surgery, in addition to cosmesis, could benefit from improved stereopsis. This improvement is associated with the performance of motor skill tasks in young adults; they reduce the risk of tripping or falling during everyday locomotion and improve reading efficiency. This study aimed to assess stereopsis level after strabismus surgery in adults who underwent strabismus surgery for any reason.

Retrospective observational study of adult patients who underwent strabismus surgery at our institution between 2010 and 2022.

One hundred and thirty-two patients were included. Postoperatively, 48% had a stereo acuity better than 100 seconds of arc, and only 21.5% had no stereopsis. The most significant factor influencing improved stereopsis after surgery was the angle of strabismus postoperatively (p = 0.018). There was a statistically significant correlation between fusion at a distance and the stereo acuity (p = 0.0337). There was no statistically significant correlation between the stereo acuity level and the strabismus angle of deviation, the strabismus direction (vertical, horizontal, or combined), or the type (esotropia or exotropia) before or after the surgery. Although not statistically significant (p = 0.6579), the underlying cause categories were correlated with the stereo level. Patients with neurological causes demonstrated higher levels of stereopsis, followed by TED, whereas patients with childhood strabismus have the lowest probability of regaining stereopsis after surgery.

Although long-standing strabismus reduces the potential for binocularity, surgery may be beneficial and improve stereopsis regardless of the cause of strabismus.