Purpose: To investigate the surgical outcomes for patients with incomitant strabismus and the satisfaction level.
Subjects and methods: The subjects included 83 patients with incomitant strabismus (mean age 56.5±15.3 years )who had undergone strabismus surgery at the Department of Ophthalmology, Hyogo College of Medicine Hospital, from January 2017 to October 2018. They were divided into three groups: a horizontal group, a vertical group (including cyclodeviation), and a mixed group (combination of horizontal and vertical deviations). We investigated strabismus type, surgical results, binocular function, elimination rate for diplopia, and satisfaction level by National Eye Institute Visual Function Questionnaire-25 (VFQ25). Ocular alignment, stereopsis, and VFQ25 were compared prior to and six months after the surgery. Stereopsis was scored, and a test of significance was performed.
Results: The horizontal group included 15 cases, the vertical group 38 cases, and the mixed group 30 cases. Ocular alignment and stereopsis showed significant improvements in all the groups (p<0.001), whereas the elimination rate for diplopia in the mixed group was significantly lower than that in the other groups (p=0.030; horizontal group: 76.9%, vertical group: 91.4%, mixed group: 61.5%). VFQ25 improved significantly in all the groups (p<0.001), and there were no significant differences among the three groups. However, with regard to the presence or absence of diplopia, the VFQ25 score was significantly higher in the group without diplopia (p<0.001), and it correlated significantly with postoperative stereopsis (p<0.001). Satisfaction was higher for decompensated superior oblique palsy and thyroid ophthalmopathy than for oculomotor nerve palsy (p=0.032).
Conclusions: The elimination rate for diplopia was highest in the vertical group. Elimination of diplopia and the degree of stereopsis correlated significantly with postoperative satisfaction. This study revealed that postoperative satisfaction differed according to the types of strabismus.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 125: 16-21, 2021.