Weldy Eric, Kerr Natalie C
University of Tennessee Hamilton Eye Institute, Memphis.
University of Tennessee Hamilton Eye Institute, Memphis.
J AAPOS. 2017 Aug;21(4):291-294. doi: 10.1016/j.jaapos.2017.05.027. Epub 2017 Jul 12.
Rectus muscle restriction is a common finding in thyroid eye disease (TED). Typically, restricted muscles are recessed to address strabismus and diplopia. However, some patients have residual strabismus following maximal recession of a restricted muscle. The purpose of this study was to report outcomes following resection of the lateral rectus muscle after maximal recession of the medial rectus muscle in patients with TED.
The medical records of patients with TED who underwent lateral rectus resection between 1998 and 2015 were reviewed retrospectively. Information regarding thyroid disease history and surgical treatment, including history of orbital decompressions, rectus muscle recessions, rectus muscle resections, and pre- and postoperative alignment was collected. Adjustable suture was used in all cases. Success was defined as a postoperative orthotropia with ≤2 of phoria at distance and a phoria at near.
A total of 11 patients were included. Of these, 10 (91%) required postoperative adjustment. A successful outcome was achieved in 10 cases (91%).
Lateral rectus muscle resection to address residual esotropia and diplopia was effective at reducing residual esotropia following medial rectus recession in our study cohort.
直肌受限是甲状腺眼病（TED）的常见表现。通常，对受限肌肉进行后徙以解决斜视和复视问题。然而，一些患者在受限肌肉最大程度后徙后仍存在残余斜视。本研究的目的是报告TED患者在内直肌最大程度后徙后行外直肌切除术的疗效。
回顾性分析1998年至2015年间接受外直肌切除术的TED患者的病历。收集有关甲状腺疾病史和手术治疗的信息，包括眼眶减压史、直肌后徙史、直肌切除术以及术前和术后的眼位情况。所有病例均使用可调节缝线。成功定义为术后远距离隐斜度≤2棱镜度且近距离有隐斜。
共纳入11例患者。其中，10例（91%）术后需要调整。10例（91%）取得了成功的结果。
在我们的研究队列中，外直肌切除术用于解决残余内斜视和复视在减少内直肌后徙后的残余内斜视方面是有效的。
