Standard strabismus surgery in thyroid ophthalmopathy.

ABSTRACT

INTRODUCTION: Techniques for the surgical treatment of thyroid related strabismus vary and include non-adjustable (standard), [postop'] adjustable suture, and a newer procedure aimed at correcting restriction rather than using dose/response tables.This study reports the results utilizing standard strabismus procedures for the treatment of thyroid ophthalmopathy. METHODS: Charts of 31 consecutive patients who underwent surgery in the pst 5 years for restrictive strabismus secondary to thyroid ophthalmopathy were retrospectively reviewed. All surgery was performed by recession and reattachment of the muscle to the globe, allowing for no postoperative adjustment. Standard doses were used for all primary surgery and slightly modified in some cases of reoperation, but the general principal was from a standard published nomogram. RESULTS: All 31 patients had preoperative diplopia and restricted motility. 22 patients wore prisms prior to surgery. Of the 31 patients who underwent surgery 9 required a second operation. After reoperation 5 patients (16%) continued to have diplopia. However, 4 of these patients were able to achieve single binocular vision with a small amount of prism. Only 2 patients were unable to achieve single binocular vision with or without prism. 22 patients (71%) had full ocular motility after surgery. After one surgery, 25 of 31 patients (81%) were satisfied with the results of surgery. This increased to 29 patients (94%) after reoperation. CONCLUSION: The results of this study indicated that strabismus surgery for restrictive thyroid ophthalmopathy using standard technique and table amounts of surgery can provide excellent results and patient satisfaction.