Non-adjustable surgery for acute acquired comitant esotropia under general anesthesia.

PURPOSE: To investigate the surgical results of the non-adjustable suture technique under general anesthesia for the correction of acute acquired comitant esotropia. STUDY DESIGN: Retrospective case study. METHODS: Patients with acute acquired comitant esotropia who underwent corrective surgery from September 2008 to June 2018 were included. Surgical treatment was conducted based on the measured maximum angle after occlusion for at least 1 h; all surgeries were performed using the non-adjustable suture technique under general anesthesia. Motor success was categorized into three groups: good, ortho; fair, 2 to 8 prism diopters (PD); and poor, over 8 PD. Sensory success was divided into two groups: good (no diplopia with binocular vision) and poor (no stereopsis with diplopia). RESULTS: 40 patients (21 male and 19 female, 28.78 ± 15.32 years old) were included. Preoperative esodeviation was 28.0 ± 12.8 PD. Mean refractive error was - 2.5 ± 2.5 D (spherical equivalent). After the occlusion of one eye, 14 patients (35%) showed an esodeviation increase of more than 5 PD. There were 70% good, 25% fair, and 5% poor outcomes regarding motor success. 96% of the patients demonstrated good sensory success. CONCLUSION: The non-adjustable correction based on the maximum angle after 1 h had a relatively excellent motor and sensory success rate.

Efficacy and Safety of Low-to-Moderate Dose Oral Corticosteroid Treatment in Ocular Myasthenia Gravis.

PURPOSE: To evaluate the response to corticosteroid therapy as a primary treatment for ocular myasthenia gravis. METHODS: Patients diagnosed as having ocular myasthenia gravis by an acetylcholine receptor binding antibody test between January 2011 and September 2015 were included in the study and started receiving treatment with a corticosteroid. Patients with a blowout fracture, hyperthyroidism, diabetes mellitus, hypertension, cardiovascular disease, or history of strabismus surgery were excluded. Disappearance of diplopia and ptosis were considered a response to treatment. RESULTS: Methylprednisolone therapy was administered to 29 patients (19 men and 10 women; average age: 49 ± 16.5 years) as an initial treatment. A total of 6 patients were lost to follow-up. Twenty-three of 29 patients (82.6%) were regarded as having presented a response to treatment. The average treatment duration was 3 weeks for patients responding to primary treatment. Eight patients complained of adverse effects from steroid therapy such as heartburn, insomnia, weight gain, and myalgia. CONCLUSIONS: A corticosteroid could be considered as an initial treatment for patients diagnosed as having ocular myasthenia gravis by an acetylcholine receptor binding antibody test. [J Pediatr Ophthalmol Strabismus. 2018;55(5):339-342.].