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Assessment of surgical strategies for management of complicated strabismus reoperation in Graves’ ophthalmopathy

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Abstract

Purpose

Strabismus reoperation in Graves’ ophthalmopathy (GO) is complicated and challenging. The purpose of this study was to evaluate the various surgical strategies of strabismus reoperation and their outcomes in patients with GO.

Methods

A retrospective study was conducted on strabismus reoperations performed at the Zhongshan Ophthalmic Center of Sun Yat-sen University, Guangzhou, China from 2008 to 2018. Data collected included sex, age at surgery, duration of deviation, ocular alignment, ocular motility, various surgical procedures performed and surgical outcomes. Surgical methods included rectus recession for newly developed strabismus, rectus resection for undercorrection and anterior advancement of a previously recessed rectus for overcorrection. Surgical success was defined as an absence of diplopia, a horizontal deviation of ≤ 10 prism diopters (PD) and a vertical deviation of ≤ 5 PD at distance in primary and reading positions.

Results

Of the 153 GO patients receiving strabismus surgery, 27 cases (20 males, 7 females) underwent reoperation for strabismus, with a reoperation rate of 17.6%. Success rates of reoperation in patients with a previous undercorrection and overcorrection were 45% and 71.4%, respectively. Success rates of rectus recession, rectus resection and anterior advancement were 47.1%, 66.7% and 50%, respectively. Two patients underwent the third surgery. The overall success rate was 51.9%.

Conclusions

Rectus recession is an effective method for GO patients with newly-developed strabismus. Rectus resection may benefit some patients with undercorrection who underwent a maximal degree of rectus recession. Anterior advancement of a previously recessed rectus is effective for cases with overcorrection.

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Funding

The study did not receive any funding.

Author information

Author notes

  1. Minghao Chen and Shiyu Tang are contributed equally to this work.

Authors and Affiliations

  1. State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 **anlie Nan Road, Guangzhou, 510060, China

    Minghao Chen, Shiyu Tang & Jianhua Yan

Authors
  1. Minghao Chen
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  2. Shiyu Tang
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  3. Jianhua Yan
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Contributions

MHC, SYT and JHY had full access to the all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: JHY. Acquisition, analysis, interpretation of data: MHC and SYT. Drafting of the manuscript: JHY, MHC and SYT.

Corresponding author

Correspondence to Jianhua Yan.

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Conflicts of interest

The authors have no conflicts of interest to declare.

Ethical approval

The Ethics Committee of the Zhongshan Ophthalmic Center approved this retrospective study (2021KYPJ184), which was conducted according to the principles expressed in the Declaration of Helsinki. The committee specifically waived the need for consent.

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Chen, M., Tang, S. & Yan, J. Assessment of surgical strategies for management of complicated strabismus reoperation in Graves’ ophthalmopathy. Int Ophthalmol 44, 278 (2024). https://doi.org/10.1007/s10792-024-03206-6

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