SURGICAL-MANAGEMENT OF STRABISMUS ASSOCIATED WITH CHRONIC PROGRESSIVEEXTERNAL OPHTHALMOPLEGIA

Purpose: The purpose of the study is to describe the clinical characte ristics and surgical management of strabismus associated with chronic progressive external ophthalmoplegia. Methods: The authors present fou r patients with chronic progressive external ophthalmoplegia and strab ismus requiring extraocular muscle surgery, with attention to presenti ng symptoms, patterns of misalignment, results of surgical and nonsurg ical therapies, and associated ocular or systemic conditions or both. Results: Three patients reported diplopia before surgery. One patient presented with an esotropia, one with an exotropia, and two with hyper tropia, Three patients required only one strabismus surgery, and one p atient required multiple surgeries. Conclusions: Chronic progressive e xternal ophthalmoplegia may have clinical characteristics similar to t hose of myasthenia gravis or thyroid ophthalmopathy. Patients with chr onic progressive external ophthalmoplegia and strabismus frequently ha ve diplopia in primary position and may benefit from extraocular muscl e surgery to improve alignment. In addition, because these patients ty pically have poor motor fusion, prisms often are useful adjuncts to su rgery.