Long-Term Follow-Up of Strabismus Surgery for Patients With Ocular Myasthenia Gravis

Background: Patients with ocular myasthenia gravis (OMG) may develop strabismus and diplopia. We completed a retrospective observational case series to evaluate long-term surgical outcomes in patients with OMG. Methods: The medical records of all patients with OMG who underwent strabismus surgery with at least 6 months of postoperative follow-up were reviewed. Nine patients met the study inclusion criteria. The main outcomes, including ocular alignment, number of surgeries, and sensory status were evaluated. Results: Of these patients, initially 2 had horizontal strabismus alone, 3 had vertical strabismus alone, 3 had both vertical and horizontal strabismus, and 1 patient had vertical and torsional strabismus. The length of preoperative stability was 2.0 +/- 2.5 years (range: 0.1-8.0 years). The mean preoperative horizontal and vertical deviations were 40.5 +/- 32.5 prism diopters (PD; range: 0-90 PD) and 25.6 +/- 36.7 PD (range: 0-120 PD), respectively. The average length of the follow-up after the first surgery was 5.7 +/- 4.2 years (range: 0.7-10.6 years). Four patients (44%) underwent 2 operations. For patients requiring a second operation, the time to second operation was 2.3 years (range: 0.4-5.0 years). Six patients (67%) were within 10 PD of orthotropia at distance in primary position at the final visit. Five patients (55%) had single vision after their surgeries. Conclusion: Strabismus surgery can achieve good long-term binocular alignment in patients with OMG. Journal of Neuro-Ophthalmology 2013; 33: 40-44 doi: 10.1097/WNO.0b013e318280d630 (C) 2013 by North American Neuro-Ophthalmology Society