Strategies for improving outcomes in strabismus surgery related to TED

The authors investigated whether initial postoperative angle of deviation impacts surgical outcomes in patients with thyroid eye disease (TED).

Study design

This was a retrospective chart review of 78 patients with hypotropia or esotropia due to TED who underwent strabismus surgery with fixed sutures. Postoperative assessment at 1 day was compared to final follow-up to assess correlation between early alignment and success.

Clinical significance

Early (postoperative day 1) undercorrection or full correction of hypotropia or showed higher rates of success at final follow-up (80% and 67%, respectively) than overcorrection (36%). Surgical correction for esotropia also showed similar results with higher final success rates in patients undercorrected (85%) or fully corrected (83%) at postoperative day 1 when compared with overcorrection (38%).

Limitation

This was a retrospective chart review with a moderate number of patients. Further, the study excluded patients with combined vertical/horizontal/torsional strabismus as well as patients who had previously undergone strabismus surgery.

Clinical significance

This study corroborates with other previous reports where late overcorrection often occurs in TED. Although this study utilized fixed sutures, this information is helpful for determining final placement of muscles with adjustable sutures