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Outcomes of Extraocular Muscle Surgery for Diplopia or Abnormal Head Posture After Treatment of Brain Disease

Authors Nishiguchi F, Kimura A, Okamoto M, Okita Y, Gomi F

Received 18 May 2020

Accepted for publication 8 July 2020

Published 27 July 2020 Volume 2020:14 Pages 2151—2157

DOI https://doi.org/10.2147/OPTH.S263256

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Fumi Nishiguchi,1,2 Akiko Kimura,1 Mana Okamoto,1 Yoichi Okita,1 Fumi Gomi1

1Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; 2Nishiguchi Eye Clinic, Kobe, Hyogo, Japan

Correspondence: Akiko Kimura
Department of Ophthalmology, Hyogo College of Medicine, 1-1 Mukogawa-Cho, Nishinomiya, Hyogo, Japan
Tel +81 798 45 6462
Fax +81 798 45 6464
Email akis@hyo-med.ac.jp

Purpose: To report the characteristics and outcomes of extraocular muscle (EOM) surgery for diplopia and abnormal head posture (AHP) after treatment of severe brain diseases such as brain tumor, severe cerebral bleeding and cerebral infarction.
Patients and Methods: Sixty-four patients (mean age 53.7 ± 16.0 years) who underwent EOM surgery to eliminate diplopia or AHP after treatment for brain disease at Hyogo College of Medicine Hospital from March 2006 through February 2018 were included. We divided the patients into two groups: a severe cerebrovascular disorder (SCVD) group and a brain tumor (BT) group. Backgrounds, surgical outcomes and satisfaction with treatment outcomes were examined retrospectively and compared between the two groups. The NEI-VFQ 25, Japanese version, was used to quantify postoperative satisfaction.
Results: There were 26 patients in the SCVD group and 38 patients in the BT group. The average age for the BT group was significantly younger than that for the SCVD group (P = 0.0236). The period from the onset of diplopia to EOM surgery was approximately 4 years for both groups. Abducens palsy was the most frequent disturbance (27% in the SCVD group and 52.6% in the BT group), and the numbers of operations were similar between the 2 groups (1.3 ± 0.7 and 1.3 ± 0.5 operations, respectively). In total, diplopia was eliminated in 82.8% of cases and AHP improved in 81.6% of cases. The BT group scored significantly higher than the SCVD group on 8 out of the 11 items on the VFQ 25.
Conclusion: EOM surgery was effective in eliminating diplopia and AHP. Therefore, we recommend that these patients visit an ophthalmologist as soon as possible and undergo EOM surgery.

Keywords: diplopia, abnormal head posture, strabismus surgery, brain disease, VFQ 25

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