Ocular muscle surgery in thyroid eye disease

This paper is about the results of muscle surgery to correct double vision and any associated compensatory head posture in 58 patients with thyroid eye disease. A strict definition of success whereby the patient has binocular single vision in the straight ahead and reading areas restored by a single operation on the muscles without the subsequent use of prisms is used. The pre-operative states which may influence the outcome of surgery are examined and it is concluded that the preferred starting point for ocular muscle surgery is that the patient is euthyroid, with proptosis less than 26 mm and that binocular single vision has thus far been maintained by the use of prisms and/or a compensatory head posture. Records of the ocular movements must have been stable for at least six months. The techniques of surgical correction are described including the use of adjustable sutures.