Table 2.
Strabismus surgery in thyroid eye disease (TED)
| Study | Sample size | Follow-up | Preoperative deviation | Muscle procedure | Outcomes and consideration |
|---|---|---|---|---|---|
| Dal Canto et al.50 Retrospective |
24 | Average 5.9 months | ET: 28 PD HT: 25 ET: 21, HT: 21 |
MR recession + IR recession IR recession ± IR recession SR recession IR recession + LR recession MR + IR + SR recession |
Excellent outcome (no diplopia without prism): 87.5% Reoperation rate: 8% Relaxed muscle positioning technique |
| Lyu et al.51 Retrospective |
43 | Median 14.2 months | Median 30 PD |
MR recession | Success rate: 86% Under-correction: 14% Adjustable sutures (n=35) |
| Jellema et al.60 Retrospective |
102 | 6-12 months | 8.7±4.9 degrees 18.1±7 degrees |
Unilateral MR recession BMR recession |
Success rate 77% Additional surgery 23% Surgical dose-response 1 degree/mm |
| Weldy and Kerr61 Retrospective |
11 | 2 months | 17.8 PD (8-30) | BLR resection Unilateral LR resection |
Success rate 91% Adjustable sutures Amount of resection 4-12 mm |
| Kim et al.62 Retrospective | 9 | 3 months | Distance: 23.1±10.3 (12-30) PD Near: 14.9±12.3 PD |
LR resection 5.1±1.6 (3-8) mm |
Success rate 78% Fixed sutures |
| Greninger et al.63 Retrospective |
47 | Average 19.5 months |
30-80 PD (ET before MR recession) 12-50 PD (residual ET after BMR recession) |
MR recession + LR resection LR recession |
All patients were free of diplopia |
| Peragallo et al.64 Retrospective |
Group A (n=13) Group B (n=13) Control (n=14) |
- | 17±9.2 PD 21.3±7.5 PD 11.2±1.3 PD |
IR recession (unilateral) | Over-correction A: 23% B: 14% Control: 16% Group A: Adjustable sutures in TED patients Group B: Fixed or semi-adjustable sutures in the cases with TED Control group: Adjustable sutures in patient with other forms of strabismus |
| Nicholson et al.65 Retrospective |
58 | Average 12.1 | - | MR recession MR + IR recession LR + IR recession IR recession |
Excellent outcome in 83% of the patients Relaxed muscle positioning technique Large horizontal deviation was associated with an increased chance for reoperation |
| Cruz and Davitt66 Retrospective |
8 | 18 months | - | IR recession | Seven patients were successfully aligned One case was under-corrected Adjustable sutures |
| Barker et al.67 Retrospective |
42 | 12 months | 21.1 PD | IR recession SR recession IR recession + SR recession |
71% were free of diplopia Adjustable sutures 19% over-correction |
| Kushner68 Retrospective |
57 (14 cases had TED) | 13.6±5.9 | - | IR recession MR recession |
None of them demonstrated muscle slippage Semi-adjustable sutures |
| Cestari et al.69 Retrospective |
Group 1 (n=9) Group 2 (n=9) |
4/3 months 4/8 months |
HOT: 24.2±7.2 HOT: 24.4±6.6 ET: 15.2±4.6 XT: 29.0±29.5 |
IR recession IR + SR recession IR ± SR + LR recession SR + IR + MR recession |
Group 1: Success rate 89% Group 2: Success rate 67% Postoperative vertical drift toward HT: Group 1: 1.2 PD Group 2: 6.8 PD P=0.048 |
| Kerr70 Retrospective | Group 1 n=34 (patient with TED) Group 2 n=30 (no TED) Group 3 n=13 (TED) |
2 months | Non-absorbable cases: 20±11.65 PD Absorbable cases: 20±13.8 PD |
IR recession Unilateral IR recession MR recession |
Absorbable suture and TED were associated with postoperative over-correction Non-absorbable suture was strongly correlated with the absence of over-correction |
| Tacea et al.71 Retrospective |
n=8 | 54±41 (range, 21-125 months) | Distance: 15.8±8.8 Near: 14.2±8.4 |
SR resection IR resection IR + SR resection |
Success rate 62.5% All the patients underwent prior maximal vertical rectus muscle recession. 37.5% of the patients required further surgery |
TED: Thyroid eye disease, ET: Esotropia, PD: Prism diopter, HT: Hypertropia, MR: Medial rectus, BMR: Bilateral medial rectus, HOT: Hypotropia, XT: Exotropia, IR: Inferior rectus, SR: Superior rectus, LR: Lateral rectus, BLR: Bilateral lateral rectus