Factors influencing stereoacuity outcomes in adults with acquired strabismus

Am J Ophthalmol. 2004 Dec;138(6):931-5. doi: 10.1016/j.ajo.2004.07.030.


Purpose: Functional improvements of binocular vision after strabismus surgery in adults are common but not well understood. In a prospective study, factors associated with stereoacuity outcome in patients with strabismus acquired following binocular vision maturation were investigated.

Design: Prospective data collection.

Methods: Twenty-three patients aged 14 to 85 years with acquired strabismus were enrolled. Random dot stereoacuity was quantified using a battery of tests including the Randot Preschool Stereoacuity test, the Randot (version 2) shapes test, and the Randot Butterfly test.

Results: Ninety-six percent of patients achieved measurable stereoacuity following successful eye realignment. Better median stereoacuity is achieved in patients with the following characteristics: < or =12 months of constant strabismus (60 vs 400 seconds of arc with >12 months' strabismus, P < .001); a presurgical capacity for fine to moderate stereopsis (60 vs 400 seconds of arc with coarse or no measurable stereopsis, P < .005); a presurgical capacity for macular fusion (60 vs 400 seconds of arc with no measurable macular fusion capacity, P < .001); and postsurgical orthotropia (100 seconds of arc) or intermittent orthotropia (100 seconds of arc vs 2000 seconds of arc with 5 to 8 prism diopters (PD) of postsurgical residual strabismus, P < .05).

Conclusion: Surgical correction of acquired strabismus is associated with recovery of stereopsis. Factors associated with stereoacuity outcomes include duration of strabismus and presurgical binocular vision capacity. A postsurgical correction of orthotropia or intermittent orthotropia supports better stereoacuity than a larger residual angle of strabismus subtending up to 8 PD of deviation.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Depth Perception / physiology*
  • Humans
  • Middle Aged
  • Oculomotor Muscles / surgery
  • Ophthalmologic Surgical Procedures
  • Prospective Studies
  • Recovery of Function / physiology
  • Strabismus / physiopathology*
  • Strabismus / surgery
  • Vision, Binocular / physiology*
  • Visual Acuity / physiology*