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Related Experiment Video

Updated: Mar 3, 2026

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Long-term Surgical Outcomes for Vertical Deviations in Thyroid Eye Disease.

Lucy Barker, Kelly Mackenzie, Gill Gw Adams

    Strabismus
    |May 3, 2017
    PubMed
    Summary

    Adjustable vertical strabismus surgery for thyroid eye disease (TED) can lead to late overcorrection. Aiming for an 8 PD undercorrection immediately after surgery may improve long-term results and reduce the need for further interventions.

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    Area of Science:

    • Ophthalmology
    • Strabismus Surgery
    • Thyroid Eye Disease

    Background:

    • Vertical deviations in thyroid eye disease (TED) pose surgical challenges due to unpredictability and risk of overcorrection.
    • Adjustable vertical strabismus surgery is a common approach for TED, but late postoperative drift can occur.

    Purpose of the Study:

    • To report postoperative outcomes of adjustable vertical strabismus surgery using Vicryl sutures in patients with TED.
    • To identify factors contributing to overcorrection and propose strategies to mitigate it.

    Main Methods:

    • Retrospective review of 42 patients with vertical TED strabismus who underwent adjustable surgery between 2005 and 2009.
    • Data collection included preoperative, post-adjustment, and 3-week, 3-month, and 1-year postoperative measurements of vertical deviation and diplopia.
    Keywords:
    overcorrectionstrabismus surgerythyroid eye diseasevertical strabismus

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    Main Results:

    • 71.4% of patients were free of diplopia postoperatively.
    • Mean near vertical deviation showed undercorrection at all follow-up points (4.0 PD at 3 weeks to 4.4 PD at 1 year).
    • Eight patients experienced overcorrection, with a significant difference in immediate post-adjustment angle between those who overcorrected and those who did not (3.1 PD vs 7.1 PD).

    Conclusions:

    • Adjustable vertical strabismus surgery for TED can result in late overcorrection and may require further intervention.
    • A strategy of aiming for an immediate post-adjustment undercorrection of 8 PD is proposed to minimize late overcorrection.
    • Preoperative patient counseling is crucial to manage expectations regarding initial undercorrection and potential temporary diplopia for better long-term outcomes.