Characteristics and outcomes of strabismus surgery after orbital decompression for thyroid eye disease

Purpose: To compare characteristics and outcomes of strabismus surgery in patients who have undergone orbital decompression for thyroid eye disease with those who have not. Subjects and methods: A chart review of all patients with thyroid eye disease requiring strabismus surgery in one physician's practice. Results: There were 36 patients in the decompression group (DG) and 14 patients in the no-decompression group (NDG). There was a significantly greater amount of preoperative esotropia in the DG (P = 0.02). There was an increased incidence of A-pattern in the DG (P = 0.09). There was a slightly higher number of operated muscles in the DG (P = 0.005). A good or excellent outcome was achieved in 93% of the NDG and in 94% of the DG (P = 0.83). Discussion: Previous studies suggest that patients requiring orbital decompression have a more complex thyroid eye disease and a lower success rate after strabismus surgery. Our findings suggest that this is not necessarily the case, and the difference in surgical success rates between the studies may in part be due to orbital decompression technique or indication. Conclusion: In this series, using a fixed suture technique, outcomes of strabismus surgery in patients with thyroid eye disease who underwent orbital decompression are similar to those who did not.