독사 교상 후 마비사시를 보이는 환자에서 항콜린에스테라제의 치료

Anticholinesterase Treatment for Patients With Paralytic Strabismus Following a Viper Bite

Purpose: To describe the therapeutic effect of anticholinesterase treatment for patients with paralytic strabismus and blepharoptosis following a viper bite Methods: A prospective non-comparative interventional case series study was designed including 6 patients with ophthalmic complications such as paralytic strabismus and blepharoptosis following a viper bite. Anticholinesterase (pyridostigmine) 60 mg was administered to patients 3 times a day in additional to conservative treatment including antivenom, antibiotics and tetanus toxoid. Patients underwent a measurement of deviation, diplopia test and MRD 1. Subjective evaluation of the diplopia symptoms was performed daily after treatment. Results: Subjective diplopia was relieved in 2 out of the 6 patients on the first day and in the other 4 patients on the second day. The angle of deviation decreased approximately 37% on the first day and ocular position became orthophoric on the third day in all patients. The blepharoptosis was completely resolved in 4 patients on the first day. No complication following anticholinesterase treatment was noticed. Conclusions: Treatment using anticholinesterase for patients suffering from diplopia and blepharoptosis following a viper bite is an effective and safe treatment. J Korean Ophthalmol Soc 2009;50(11):1698-1704