Skip to main content
PMC home page
Transactions of the American Ophthalmological Society logoLink to Transactions of the American Ophthalmological Society
. 1993;91:67–84.

Treatment of thyroid ocular myopathy with adjustable and nonadjustable suture strabismus surgery.

D J Kraus 1, J D Bullock 1
PMCID: PMC1298460  PMID: 8140707

Abstract

Our results pooled with those of others demonstrate a statistically significant improvement in outcome when adjustable sutures are implemented in the treatment of thyroid ocular myopathy. To our knowledge, this degree of significance has not been reported previously. We believe the value of adjustable suture strabismus surgery lies mainly in the prevention of large undercorrections and overcorrections. However, one cannot guarantee fusion or long-term alignment stability, especially without prism use. A randomized, prospective, controlled study to compare the nonadjustable and adjustable techniques for the treatment of thyroid ocular myopathy has yet to be performed. The success of any type of strabismus surgery relies on many factors. Future endeavors should implement the quantified adjustable suture technique to better define how preoperative conditions influence the response to strabismus surgery in Graves' patients.

Full text

PDF
70

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Dyer J. A. Ocular muscle surgery in Graves' disease. Trans Am Ophthalmol Soc. 1978;76:125–139. [PMC free article] [PubMed] [Google Scholar]
  2. Ellis F. D., Helveston E. M. Special considerations and techniques in strabismus surgery. Int Ophthalmol Clin. 1976 Fall;16(3):247–254. [PubMed] [Google Scholar]
  3. Ellis F. D. Strabismus surgery for endocrine ophthalmopathy. Ophthalmology. 1979 Dec;86(12):2059–2063. doi: 10.1016/s0161-6420(79)35289-7. [DOI] [PubMed] [Google Scholar]
  4. Eustis H. S., Ellis G. S., Jr Delayed conjunctival closure in adjustable sutures. South Med J. 1987 Jun;80(6):738–740. doi: 10.1097/00007611-198706000-00018. [DOI] [PubMed] [Google Scholar]
  5. Evans D., Kennerdell J. S. Extraocular muscle surgery for dysthyroid myopathy. Am J Ophthalmol. 1983 Jun;95(6):767–771. doi: 10.1016/0002-9394(83)90062-4. [DOI] [PubMed] [Google Scholar]
  6. Fells P. The use of adjustable sutures. Trans Ophthalmol Soc U K. 1981;101(Pt 2):279–283. [PubMed] [Google Scholar]
  7. Helveston E. M., Ellis F. D. Adjustable sutures for horizontal and vertical strabismus. Am Orthopt J. 1978;28:18–23. [PubMed] [Google Scholar]
  8. Hudson H. L., Feldon S. E. Late overcorrection of hypotropia in Graves ophthalmopathy. Predictive factors. Ophthalmology. 1992 Mar;99(3):356–360. doi: 10.1016/s0161-6420(92)31965-7. [DOI] [PubMed] [Google Scholar]
  9. Jampolsky A. Current techniques of adjustable strabismus surgery. Am J Ophthalmol. 1979 Sep;88(3 Pt 1):406–418. doi: 10.1016/0002-9394(79)90641-x. [DOI] [PubMed] [Google Scholar]
  10. Keech R. V., Scott W. E., Christensen L. E. Adjustable suture strabismus surgery. J Pediatr Ophthalmol Strabismus. 1987 Mar-Apr;24(2):97–102. doi: 10.3928/0191-3913-19870301-11. [DOI] [PubMed] [Google Scholar]
  11. Kendler D. L., Lippa J., Rootman J. The initial clinical characteristics of Graves' orbitopathy vary with age and sex. Arch Ophthalmol. 1993 Feb;111(2):197–201. doi: 10.1001/archopht.1993.01090020051022. [DOI] [PubMed] [Google Scholar]
  12. Kulla S., Moore S. Orthoptics in Graves' disease. Ophthalmology. 1979 Dec;86(12):2053–2058. doi: 10.1016/s0161-6420(79)35290-3. [DOI] [PubMed] [Google Scholar]
  13. Kushner B. J. A surgical procedure to minimize lower-eyelid retraction with inferior rectus recession. Arch Ophthalmol. 1992 Jul;110(7):1011–1014. doi: 10.1001/archopht.1992.01080190117039. [DOI] [PubMed] [Google Scholar]
  14. Kushner B. J., Vrabec M. Theoretical effects of surgery on length tension relationships in extraocular muscles. J Pediatr Ophthalmol Strabismus. 1987 May-Jun;24(3):126–131. doi: 10.3928/0191-3913-19870501-07. [DOI] [PubMed] [Google Scholar]
  15. Lee J., O'Day J., Fells P. Early experience with adjustable squint surgery at Moorfields Eye Hospital with long-term follow-up. Trans Ophthalmol Soc U K. 1985;104(Pt 6):662–674. [PubMed] [Google Scholar]
  16. Lennerstrand G. Adjustable sutures in strabismus surgery. A follow-up study. Acta Ophthalmol (Copenh) 1982 Oct;60(5):717–728. doi: 10.1111/j.1755-3768.1982.tb06732.x. [DOI] [PubMed] [Google Scholar]
  17. Maillette de Buy Wenniger-Prick L. J., Van Mourik-Noordenbos A. M., Koornneef L. Squint surgery in patients with Graves' ophthalmopathy. Doc Ophthalmol. 1986 Jan 15;61(3-4):219–221. doi: 10.1007/BF00142345. [DOI] [PubMed] [Google Scholar]
  18. McNeer K. W. Adjustable sutures of the vertical recti. J Pediatr Ophthalmol Strabismus. 1982 Sep-Oct;19(5):259–264. doi: 10.3928/0191-3913-19820901-18. [DOI] [PubMed] [Google Scholar]
  19. Metz H. S. Adjustable suture strabismus surgery. Ann Ophthalmol. 1979 Oct;11(10):1593–1597. [PubMed] [Google Scholar]
  20. Morris R. J., Luff A. J. Adjustable sutures in squint surgery. Br J Ophthalmol. 1992 Sep;76(9):560–562. doi: 10.1136/bjo.76.9.560. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Mourits M. P., Koorneef L., van Mourik-Noordenbos A. M., van der Meulen-Schot H. M., Prummel M. F., Wiersinga W. M., Berghout A. Extraocular muscle surgery for Graves' ophthalmopathy: does prior treatment influence surgical outcome? Br J Ophthalmol. 1990 Aug;74(8):481–483. doi: 10.1136/bjo.74.8.481. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Pratt-Johnson J. A. Adjustable-suture strabismus surgery: a review of 255 consecutive cases. Can J Ophthalmol. 1985 Apr;20(3):105–109. [PubMed] [Google Scholar]
  23. Rosenbaum A. L., Metz H. S., Carlson M., Jampolsky A. J. Adjustable rectus muscle recession surgery. A follow-up study. Arch Ophthalmol. 1977 May;95(5):817–820. doi: 10.1001/archopht.1977.04450050095010. [DOI] [PubMed] [Google Scholar]
  24. Scott W. E., Thalacker J. A. Diagnosis and treatment of thyroid myopathy. Ophthalmology. 1981 Jun;88(6):493–498. doi: 10.1016/s0161-6420(81)34988-4. [DOI] [PubMed] [Google Scholar]
  25. Skov C. M., Mazow M. L. Managing strabismus in endocrine eye disease. Can J Ophthalmol. 1984 Oct;19(6):269–274. [PubMed] [Google Scholar]
  26. Trokel S. L., Jakobiec F. A. Correlation of CT scanning and pathologic features of ophthalmic Graves' disease. Ophthalmology. 1981 Jun;88(6):553–564. doi: 10.1016/s0161-6420(81)34993-8. [DOI] [PubMed] [Google Scholar]
  27. Vrabec M. P., Preslan M. W., Kushner B. J. Oculocardiac reflex during manipulation of adjustable sutures after strabismus surgery. Am J Ophthalmol. 1987 Jul 15;104(1):61–63. doi: 10.1016/0002-9394(87)90294-7. [DOI] [PubMed] [Google Scholar]
  28. Weston B., Enzenauer R. W., Kraft S. P., Gayowsky G. R. Stability of the postoperative alignment in adjustable-suture strabismus surgery. J Pediatr Ophthalmol Strabismus. 1991 Jul-Aug;28(4):206–211. doi: 10.3928/0191-3913-19910701-05. [DOI] [PubMed] [Google Scholar]

Articles from Transactions of the American Ophthalmological Society are provided here courtesy of American Ophthalmological Society

RESOURCES