The surgical management of restrictive strabismus caused by thyroid-associated ophthalmopathy

Abstract

Objective To investigate the clinical features of restrictive strabismus caused by thyroid-associated ophthalmopathy (TAO) and the effect of rectus tenotomy for restrictive strabismus. Methods Thirty-seven TAO patients with restrictive strabismus were collected in our hospital. For every patient, the most restricted extraocular muscles were determined by monocular cover, eye movement and passive traction test. Rectus tenotomy only or combined with shortening the antagonist mucle was performed on the most restricted one or more muscles.The position of eyes, eyes movements and diplopia were measured pre- and post-operatively. Results All the patients had good results.Thirty-two patients (86.5%) had the elimination of diplopia, significant improvement of eye movements in every direction and the strabismus angle less then 5°. Four cases had obvious improvements and one case was undercorrection. Four patients had postoperative complicated eyelid retraction. Conclusion Rectus tenotomy can effectively eliminate restrictive strabismus caused by TAO. Key words: Thyroid-associated ophthalmopathy; Strabismus, restrictive; Rectus tenotomy