Objective To evaluate the long term effect of corrective surgery in adult strabismic patients with visual impairment； to study the stability of postoperative alignment and factors that influence it. Methods This was a retrospective clinically controlled study of the alignment， binocular vision， ocular movement and quality of life in 72 adult strabismic patients with visual impairment （BCVA less than 0.3 in one or both eyes）. These patients were compared to 79 patients without visual impairment. Data were analyzed using an independent samples t test， χ² test， rank sum test and logisitic regression analysis. Results There was no significant difference in the success rate between the two groups within 2 years after surgery （χ2=1.97， P>0.05）. Forty-eight （67%， 48/72） and sixty-six （84%， 66/79） were defined as ″successful″ at the last follow-up in the visually impaired group and control group， respectively. The difference was significant（χ2=6.14， P<0.05）. Of the 24 patients defined as ″not successful″ in the visually impaired group， 22 cases were under-corrected and 2 cases were over-corrected. Three patients and 34 patients achieved normal or partial stereoacuity in the visually impaired and control groups， respectively. The difference in stereoacuity between the two groups was significant （χ2=31.34， P＜0.01）. The scores from the quality of life questionnaire were lower in the visually impaired group than in the control group （t=-3.30， -3.72， -3.77， P＜0.01）. Conclusion Approximately two in three patients with visual impairment can achieve long-term successful outcomes with corrective surgery. However， alignment stability， binocular vision and quality of life were worse in patients with visual impairment than in those without visual impairment.