Strabismus surgery for diplopia in chronic progressive external ophthalmoplegia

  • Klio I. Chatzistefanou
  • Dimitrios Brouzas
  • Ioannis Asproudis
  • Efthimia Tsina
  • Konstantinos D. Droutsas
  • Chryssanthi Koutsandrea
Case Report



To report midterm outcomes of strabismus strategy for management of diplopia in chronic progressive external ophthalmoplegia and specific surgical planning rationale.


Retrospective interventional case series.


Two patients, a 26-year-old male and a 36-year-old female, diagnosed with chronic progressive external ophthalmoplegia presented with blepharoptosis and intermittent diplopia. Ocular motility examination was significant for bilateral profound impairment of adduction with relative preservation of abduction, infraduction and elevation. Control of intermittent exotropia gradually worsened over 3 and 1.5 years of follow-up, respectively, in the presence of documented stability of the angle of exodeviation. Strabismus surgery involving modest amounts of bilateral medial rectus resection and lateral rectus recessions was undertaken. Surgical intervention was successful in controlling alignment in primary position and alleviating diplopia and asthenopia after 9 and 8 years of follow-up time, respectively, despite slow progression of ophthalmoplegia.


Bilateral selective impairment of adduction and intermittent exotropia may be the presenting ocular motility disturbance in chronic progressive external ophthalmoplegia. Properly designed strabismus surgery may provide sustainable, in the midterm, control of alignment and symptomatic relief in selected patients with CPEO.


Chronic progressive external ophthalmoplegia Strabismus surgery Diplopia management in CPEO 


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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Klio I. Chatzistefanou
    • 1
  • Dimitrios Brouzas
    • 1
  • Ioannis Asproudis
    • 2
  • Efthimia Tsina
    • 3
  • Konstantinos D. Droutsas
    • 1
  • Chryssanthi Koutsandrea
    • 1
  1. 1.Strabismus Service, First Department of OphthalmologyNational and Kapodistrian University of Athens School of MedicineAthensGreece
  2. 2.Department of OphthalmologyUniversity Hospital of IoanninaIoanninaGreece
  3. 3.Department of OphthalmologyAthens General Pediatric Hospital “Aghia Sophia”AthensGreece

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