Abstract
Purpose :
The intraoperative relaxed muscle positioning technique (IRMPT) for strabismus in thyroid eye disease (TED) involves recessing restricted muscles’ insertions to positions on the globe where they rest without tension. This study seeks to report and evaluate the long-term outcomes of this technique.
Methods :
The charts of patients with TED and diplopia who underwent IRMPT between 1999 and 2021 were reviewed. Demographic characteristics, initial surgical outcomes, reoperation outcomes, and those at last follow up were evaluated. Excellent outcomes were defined as having no diplopia in primary and reading gazes without prism; good outcomes as diplopia in primary or reading gazes requiring ≤ 10 prism diopters in prisms; and poor when diplopia persisted.
Results :
129 patients were followed for an average of 4.24 years (range 0.01 – 20.66 years). 96 (73.8%) underwent one surgery. Of the 29 patients who underwent Bilateral Inferior Rectus and Medial Rectus Recession, nine required a second procedure, of whom two had a third procedure. 22 (73.3%) had an excellent outcome and 4 (13.3%) had a good outcome. Of the 23 Unilateral Inferior Rectus Recessions only six required a second procedure. 18 (78.3%) had an excellent outcome and 4 (21.7%) had a good outcome. Overall 121 (93.8%) patients experienced good or excellent results (Excellent, 76.7% and good, 12.7%). Additional analysis was done.
Conclusions :
IRMPT for strabismus repair in TED results in durable relief of diplopia in a large majority of patients. Patients with greater horizontal deviations, disease reactivation, and prior interventions were more likely to require re-operations.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.