Does restoration of binocular vision make any difference in the quality of life in adult strabismus.

Background: To report the effect of restoration of binocular functions in adult strabismus on the health-related quality of life (HRQOL).

Methods: 61 adults undergoing strabismus surgery completed Adult Strabismus-20 (AS-20) and Amblyopia and Strabismus (A&SQ) HRQOL questionnaires preoperatively and postoperatively. Patients were grouped according to their responses to binocular tests as binocular vision positive (BVP) and binocular vision negative (BVN) groups. Changes in AS-20 and A&SQ scores of the overall group and the subgroups were evaluated.

Results: Motor success was 90%, and 43% of the cohort showed measurable level stereopsis and central fusion on the Worth four-dot test or on the synoptophore. HRQOL scores (composite, psychosocial and functional) of the cohort measured by AS-20 and A&SQ showed significant improvement after surgery (AS-20: 42,40,45 vs 85,86,84, AS&Q: 46,52,38 vs 76,75,78, p<0.05 for all comparisons). But the BVP (n-26) group was not found superior to the BVN (n-35) group both functionally and psychosocially (p>0.05). Only after the exclusion of the amblyopic patients, functional superiority of the BVP group (n-20) over the BVN group (n-20) was disclosed (AS-20: 45 vs 31, A&SQ: 28 vs 16, p<0.05), while the composite and psychosocial subscale score improvements were not different (AS-20: 44,40 vs 34,38, A&SQ: 30,38 vs 20,37, p>0.05 for all comparisons).

Conclusions: The restoration of binocular vision is possible in adults with a long-term history of strabismus and both AS-20 and A&SQ questionnaires are sensitive to detect additive effect of binocular vision on functional aspects of the quality of life. To increase this sensitivity, questionnaires can be modified to include items inquiring tasks that require fine stereopsis.