title: Binocular vision outcomes following surgery for long-standing large angle exodeviation.
abstract: BACKGROUND
  One goal of pre-operative sensorimotor testing is to determine fusion potential. Potential for recovery of binocularity following surgical repair of strabismus is inversely correlated to duration of misalignment. The purpose of this study was to determine binocular vision outcomes in long-standing, large-angle, constant exotropia, when the pre-operative sensorimotor exam predicts poor sensory outcome.
  
  
  METHODS
  Patients with constant exotropia >35Δ, present for ≥20 years, and scheduled to undergo strabismus surgery were recruited. Subjects were sorted into 3 groups based on pre-operative sensorimotor results. Group A had evidence of fusion pre-operatively, Group B demonstrated suppression on all tests, and Group C demonstrated paradoxical diplopia on at least one test.
  
  
  RESULTS
  Twenty patients were included: 11 in Group A, 5 in Group B, and 4 in Group C. Binocular vision was regained following surgery by 100% in Group A, 80% in Group B, and 50% in group C.
  
  
  CONCLUSIONS
  Surgical realignment leads to improvements in binocular vision in most patients, even in the case of very long-standing, large, constant deviations. The presence of paradoxical diplopia or dense suppression pre-operatively does not preclude a good sensory outcome.
authors.affiliation: Ross Eye Institute, University at Buffalo, Buffalo, New York, USA. ligill@theeyecaregroup.com
authors.forename: Lindsay K
authors.initials: LK
authors.lastname: Gill
authors.forename: Kyle
authors.initials: K
authors.lastname: Arnoldi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005099:Exotropia / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D015348:Vision, Binocular / Q000502:physiology*; D055815:Young Adult