Rectus muscle resection in Graves' ophthalmopathy.

Journal Article (Journal Article)

BACKGROUND: In the treatment of Graves' ophthalmopathy, rectus muscle resections generally are avoided because of the concern of reaggravating inflammation and creating excessive extraocular muscle restriction. In patients with large-angle strabismus and in patients with residual strabismus after maximal recession surgery, however, rectus muscle resection may be considered. We report a series of 8 patients with Graves' ophthalmopathy who underwent rectus muscle resections. METHODS: The records of 270 patients with Graves' ophthalmopathy who had undergone strabismus surgery were retrospectively reviewed. Data from subjects who had undergone rectus muscle resections were collected, including age at surgery, duration of disease, duration of diplopia, previous eye or strabismus surgeries, history of radioactive iodine or corticosteroid treatment, current thyroid medications, current use of corticosteroids, tobacco use, and signs and symptoms used to diagnose Graves' ophthalmopathy. RESULTS: Eight patients (5 females) were identified (mean age, 51.1 ± 17.6 years). Preoperatively, 4 patients had a horizontal deviation and 4 patients had both horizontal and vertical deviations in primary gaze. Mean preoperative horizontal deviation was 27.9(Δ) ± 15.2(Δ) and mean vertical deviation was 6.3(Δ) ± 5.4(Δ). At final follow-up examination, 7 patients were orthotropic in primary gaze; 1 patient had a larger deviation from slippage as the result of a broken suture within the first postoperative week. None of the patients were overcorrected or developed atypical inflammation. CONCLUSIONS: In this series, patients with Graves' ophthalmology were successfully treated with the use of rectus muscle resections as part of the surgical plan. Careful ocular motility assessment and patient selection is critical if this option is contemplated.

Full Text

Duke Authors

Cited Authors

  • Yoo, SH; Pineles, SL; Goldberg, RA; Velez, FG

Published Date

  • February 2013

Published In

Volume / Issue

  • 17 / 1

Start / End Page

  • 9 - 15

PubMed ID

  • 23352720

Pubmed Central ID

  • PMC3715128

Electronic International Standard Serial Number (EISSN)

  • 1528-3933

Digital Object Identifier (DOI)

  • 10.1016/j.jaapos.2012.09.018


  • eng

Conference Location

  • United States