Critical Appraisal of Functional Outcomes after Surgical Correction of Childhood Large-Angle Exotropia in Adults

Abstract

Surgical correction of longstanding childhood exotropia in adults has traditionally been regarded as a cosmetic procedure with limited potential for restoring binocular vision. However, published evidence suggests that functional improvement, including recovery of stereopsis in selected patients, may also be achieved. This critical review evaluates the available evidence regarding postoperative binocular vision, stereopsis, sensory fusion, and health-related quality of life (HRQOL). The strengths and limitations of the published studies, together with factors influencing surgical outcomes, are critically discussed. Although the available evidence is limited by relatively small study populations and methodological heterogeneity, most studies report improvements in ocular alignment, binocular function, and quality of life following successful surgery. The findings suggest that adult strabismus surgery may provide functional as well as cosmetic benefits. Further well-designed studies are needed to strengthen the evidence base.