Early strabismus surgery in patients with strabismus and amblyopia: a therapeutic outcomes study
4 affiliations
- 1Guangxi Academy of Medical Sciences, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Zhuang Autonomous Region, Nanning, 530021 China
- 2The Second People’s Hospital of Qinzhou, Guangxi Zhuang Autonomous Region, Qinzhou, 535000 China
- 3Liuzhou Worker’s Hospital, Guangxi Zhuang Autonomous Region, Liuzhou, 545007 China
- 4Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region 530021 China
Abstract
Background: Early strabismus surgery may improve visual outcomes in patients with coexisting strabismus and amblyopia; however, the optimal timing of surgical intervention remains uncertain. This study evaluated the efficacy of early surgical correction and explored the appropriate timing of surgery in this population.
Methods: This retrospective case series included 40 patients (age range, 3–23 years) diagnosed with concomitant strabismus and amblyopia at the Ophthalmology Department of the First Affiliated Hospital of Guangxi Medical University between January 2019 and October 2022. All patients showed a suboptimal response to 3–6 months of standardized amblyopia treatment, defined as visual acuity improvement of less than two lines on a standard visual acuity chart, with a stable angle of deviation, defined as variation ≤ 5 prism diopters. Patients underwent strabismus surgery followed by continued amblyopia therapy. The median follow-up duration was 6.0 months (interquartile range [IQR], 3.0–9.75 months). Clinical parameters included surgical age, sex, strabismus type (esotropia or exotropia), amblyopia severity, best-corrected visual acuity (BCVA), ocular alignment in prism diopters, and binocular vision function, including simultaneous perception and stereopsis. Preoperative and postoperative outcomes were compared using a self-controlled design; subgroup analyses were performed for esotropia and exotropia.
Results: Postoperative BCVA in amblyopic eyes improved significantly from 0.35 logMAR (IQR, 0.25–0.68) to 0.18 logMAR (IQR, 0.1–0.3; P < 0.001), with a mean improvement of 0.23 ± 0.19 logMAR. Orthophoria was achieved in 87.5% of cases; five patients showed recurrent deviation, including one requiring reoperation. Recovery of binocular function, viz. simultaneous vision was achieved in 60.0% of patients; stereopsis was achieved in 23.3% of patients. Younger age at surgery was significantly associated with greater improvement in BCVA (P = 0.001). Final BCVA, alignment success, and binocular outcomes remained comparable between esotropia and exotropia eyes (all P > 0.05).
Conclusions: In patients with coexisting strabismus and amblyopia exhibiting suboptimal response to conservative therapy but with stable deviations, early surgical correction combined with postoperative amblyopia management demonstrates potential early emergence of significant visual gains, robust binocular recovery, and maintenance of ocular stability. However, interpretations should consider the study’s retrospective, short-term, and uncontrolled design.
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BibTeX
@article{liang2026early,
title = {{Early strabismus surgery in patients with strabismus and amblyopia: a therapeutic outcomes study}},
author = {Yiming Liang and Fangjiao Tang and Qiuling Du and Dan Chen and Jinmao Chen},
journal = {BMC Ophthalmology},
year = {2026},
month = jul,
doi = {10.1186/s12886-026-05178-w},
url = {https://doi.org/10.1186/s12886-026-05178-w},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Early strabismus surgery in patients with strabismus and amblyopia: a therapeutic outcomes study
AU - Yiming Liang
AU - Fangjiao Tang
AU - Qiuling Du
AU - Dan Chen
AU - Jinmao Chen
PY - 2026
DA - 2026/07/31
JO - BMC Ophthalmology
DO - 10.1186/s12886-026-05178-w
UR - https://doi.org/10.1186/s12886-026-05178-w
AB - Background: Early strabismus surgery may improve visual outcomes in patients with coexisting strabismus and amblyopia; however, the optimal timing of surgical intervention remains uncertain. This study evaluated the efficacy of early surgical correction and explored the appropriate timing of surgery in this population. Methods: This retrospective case series included 40 patients (age range, 3–23 years) diagnosed with concomitant strabismus and amblyopia at the Ophthalmology Department of the First Affiliated Hospital of Guangxi Medical University between January 2019 and October 2022. All patients showed a suboptimal response to 3–6 months of standardized amblyopia treatment, defined as visual acuity improvement of less than two lines on a standard visual acuity chart, with a stable angle of deviation, defined as variation ≤ 5 prism diopters. Patients underwent strabismus surgery followed by continued amblyopia therapy. The median follow-up duration was 6.0 months (interquartile range [IQR], 3.0–9.75 months). Clinical parameters included surgical age, sex, strabismus type (esotropia or exotropia), amblyopia severity, best-corrected visual acuity (BCVA), ocular alignment in prism diopters, and binocular vision function, including simultaneous perception and stereopsis. Preoperative and postoperative outcomes were compared using a self-controlled design; subgroup analyses were performed for esotropia and exotropia. Results: Postoperative BCVA in amblyopic eyes improved significantly from 0.35 logMAR (IQR, 0.25–0.68) to 0.18 logMAR (IQR, 0.1–0.3; P < 0.001), with a mean improvement of 0.23 ± 0.19 logMAR. Orthophoria was achieved in 87.5% of cases; five patients showed recurrent deviation, including one requiring reoperation. Recovery of binocular function, viz. simultaneous vision was achieved in 60.0% of patients; stereopsis was achieved in 23.3% of patients. Younger age at surgery was significantly associated with greater improvement in BCVA (P = 0.001). Final BCVA, alignment success, and binocular outcomes remained comparable between esotropia and exotropia eyes (all P > 0.05). Conclusions: In patients with coexisting strabismus and amblyopia exhibiting suboptimal response to conservative therapy but with stable deviations, early surgical correction combined with postoperative amblyopia management demonstrates potential early emergence of significant visual gains, robust binocular recovery, and maintenance of ocular stability. However, interpretations should consider the study’s retrospective, short-term, and uncontrolled design.
SN - 1471-2415
ER -