Outcomes of the intraoperative relaxed muscle positioning technique in strabismus surgery for thyroid eye disease

Thyroid eye disease (TED) can cause incomitant strabismus with muscle restriction, resulting in diplopia and patient discomfort and discontent. Surgical correction of TED-associated restrictive strabismus has been attempted, with fixed and adjustable suture success rates varying from 38% to 82%. This paper reviews five articles that explored the utility of the intraoperative relaxed muscle positioning (IRMP) technique in patients with restrictive strabismus due to TED. While IRMP is a useful technique for addressing TED-related strabismus and is effective in patients with incomitant strabismus, disease reactivation, staged and unplanned surgeries, combined horizontal and vertical deviations, and previous orbital decompression surgeries, it is probable that this approach can be utilized in children with restrictive types of strabismus. Therefore, further studies are required.