Surgical outcome of strabismus surgery in patients with unilateral vision loss and horizontal strabismus.

Abstract

To report on the surgical outcome of horizontal strabismus surgery in patients diagnosed as having unilateral vision loss. Medical records of all patients with unilateral vision loss who underwent surgical repair of horizontal strabismus between 2008 and 2013 at three medical centers were reviewed. Data collected included age at time of surgery, type of strabismus, preoperative and postoperative deviation, procedure performed, and length of follow-up. Surgical success was defined as final alignment of 10 prism diopters (PD) or less unless more than one surgery was required to realign the eyes. Twenty-one patients (9 children) were reviewed. Mean age at time of surgery was 28.3 years (range: 3 to 64 years) and mean follow-up was 20 months (range: 6 months to 5 years). Mean preoperative logMAR visual acuity in the deviating eyes (14 right eyes) was 1.4 ± 0.7 (range: 1.0 to 2.8) and mean deviation was 33 PD (range: 15 to 90 PD). All procedures were performed only on the deviating eye (13 recessions and 8 recession-resection procedures). Mean postoperative deviation was 6.4 PD (range: 0 to 25 PD) and 81% of patients had a manifest ocular deviation of 10 PD or less. Surgical success was comparable in children versus adults (P = .603), in patients with esotropia versus exotropia (P = 1.000), in patients with preoperative deviations larger than 30 PD compared to patients with smaller deviations (P = .521), and in patients in whom one muscle was operated on compared to all other patients (P = .617). Strabismus surgery in patients with unilateral vision loss is often successful in correcting ocular misalignment.