Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"


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Abstract
Abstract

Strabismus Surgery in Thyroid Ophthalmopathy

Schittkowski M., Fichter N., Guthoff R.
Rostock University, Department of Ophthalmology, Rostock

Purpose: Strabismus in thyroid ophthalmopathy is based on contractility and distensibility loss of external ocular muscels. There are different therapeutic approaches existing, like recession after pre- or intraoperative measurement, adjustable sutures, antagonist resection, or contralateral synergist fadenoperation.
Method: 42 muscles in 25 patients with thyroid ophthalmopathy have been operated between 2000 and 2002: in 24 eyes of 21 patients inferior rectus muscle recession, in 12 eyes of 7 patients internus muscle recession, fadenoperation on contralateral inferior rectus in 3 patients. Bevor proceeding with corrective surgery, we waited at least 6 months after stabilization of ocular alignment and normalization of thyroid chemistries. All patients were seen preoperative and 1-2 days and 3-6 months postoperative.
Results: Preoperative vertical deviation was 10-42 PD (mean 10.3), 3 months postoperative -4-6 PD (mean 1.2). Preoperative horizontal deviation was 8-40 PD (mean 8.3), 3 months postoperative -2-4 PD (mean 0.7). Recession of the fibrotic muscle leads to reproducible results: 4.1±0.7 PD vertical deviation / mm for inferior rectus and 3.4±0.74 PD horizontal deviation / mm for internal rectus when operated bilateral. 3 patients were operated twice, 2 due to overcorrection and 1 due to undercorrection. In case of large preoperative deviation a correction should be expected, which might not be sufficient in the first


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