Abstract
We aim to present surgical outcomes of patients who underwent strabismus surgery for large angle/severe thyroid related strabismus using a modified relaxed muscle positioning technique.
A retrospective case note review of patients with large angle strabismus and or severe restricted motility who underwent surgery using the relaxed muscle technique from Dec 2015- Dec 2023. Large angle strabismus was defined as horizontal deviation measuring >30 prism dioptres horizontally or vertical deviation > 20 prism dioptres in primary position. Severe restricted motility was defined as ocular motility restriction of -2 or greater.
A total of 15 cases were included in analyses. All patients except 1 required more than 1 operation. The average horizontal deviation post-operative deviation measured 6^(±5) at 1/3m and 8^(±7) at 6m. The average vertical post-operative deviation measured 5^ (±5) at 1/3m and 5^ (±5) at 6m fixation. In terms of binocular outcome, 8/13 patients with binocular potential achieved an excellent outcome and 4/13 achieved a good outcome according to Delcanto’s criteria. 1 patient achieved a good outcome after a second procedure.
Strabismus surgery for thyroid orbitopathy using the relaxed muscle technique provides excellent surgical alignment and restores binocular function in most cases. Our results suggest that this technique can be used to effectively manage complex thyroid related strabismus without adjustable sutures and without need for many repeated surgeries.