Abstract
Purpose: To describe surgical management and outcomes for large-angle esotropia of ≥50 Δ secondary to Graves ophthalmopathy using combined initial nonadjustable medial rectus recessions and lateral rectus resections. Methods: The medical records of consecutive patients undergoing strabismus surgery for large-angle esotropia secondary to Graves ophthalmopathy from 1995 to 2012 by a single surgeon at each of two institutions was performed. Patient characteristics, surgical technique, and pre- and postoperative measurements of ocular alignment were analyzed. A modified Gorman diplopia scale was used to assess outcome. Results: Of 38 patients, 36 had bilateral nonadjustable medial rectus recessions and lateral rectus resections as initial treatment for esotropia, and 6 patients underwent simultaneous vertical muscle surgery. Mean preoperative horizontal deviation was 60 Δ and mean preoperative vertical deviation was 10 Δ . Of the 38 patients, 19 (50%) reached the primary outcome, including 5 of 6 (85%) who had no preoperative vertical strabismus. The indications for reoperation were vertical strabismus in 13 of 21 patients (62%), residual esotropia in 7 of 21 (33%), and consecutive exotropia in 1 of 21 (5%). With a median follow-up of 13.2 months after first surgery, 32 of 38 patients (84%) reached the secondary outcome. Conclusions: Combining nonadjustable medial rectus recessions with lateral rectus resections can be a beneficial primary treatment for large-angle esotropia in patients with Graves ophthalmopathy, especially in those patients with small or no associated vertical strabismus.(Figure presented.)
| Original language | English (US) |
|---|---|
| Pages (from-to) | 15.e1-15.e5 |
| Journal | Journal of AAPOS |
| Volume | 23 |
| Issue number | 1 |
| DOIs | |
| State | Published - Feb 1 2019 |
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ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Ophthalmology
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The management of large-angle esotropia in Graves ophthalmopathy with combined medial rectus recession and lateral rectus resection. / Garrity, James A.; Greninger, Daniel A.; Ekdawi, Noha S.; Steele, Eric.
In: Journal of AAPOS, Vol. 23, No. 1, 01.02.2019, p. 15.e1-15.e5.Research output: Contribution to journal › Article
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TY - JOUR
T1 - The management of large-angle esotropia in Graves ophthalmopathy with combined medial rectus recession and lateral rectus resection
AU - Garrity, James A.
AU - Greninger, Daniel A.
AU - Ekdawi, Noha S.
AU - Steele, Eric
PY - 2019/2/1
Y1 - 2019/2/1
N2 - Purpose: To describe surgical management and outcomes for large-angle esotropia of ≥50 Δ secondary to Graves ophthalmopathy using combined initial nonadjustable medial rectus recessions and lateral rectus resections. Methods: The medical records of consecutive patients undergoing strabismus surgery for large-angle esotropia secondary to Graves ophthalmopathy from 1995 to 2012 by a single surgeon at each of two institutions was performed. Patient characteristics, surgical technique, and pre- and postoperative measurements of ocular alignment were analyzed. A modified Gorman diplopia scale was used to assess outcome. Results: Of 38 patients, 36 had bilateral nonadjustable medial rectus recessions and lateral rectus resections as initial treatment for esotropia, and 6 patients underwent simultaneous vertical muscle surgery. Mean preoperative horizontal deviation was 60 Δ and mean preoperative vertical deviation was 10 Δ . Of the 38 patients, 19 (50%) reached the primary outcome, including 5 of 6 (85%) who had no preoperative vertical strabismus. The indications for reoperation were vertical strabismus in 13 of 21 patients (62%), residual esotropia in 7 of 21 (33%), and consecutive exotropia in 1 of 21 (5%). With a median follow-up of 13.2 months after first surgery, 32 of 38 patients (84%) reached the secondary outcome. Conclusions: Combining nonadjustable medial rectus recessions with lateral rectus resections can be a beneficial primary treatment for large-angle esotropia in patients with Graves ophthalmopathy, especially in those patients with small or no associated vertical strabismus.(Figure presented.)
AB - Purpose: To describe surgical management and outcomes for large-angle esotropia of ≥50 Δ secondary to Graves ophthalmopathy using combined initial nonadjustable medial rectus recessions and lateral rectus resections. Methods: The medical records of consecutive patients undergoing strabismus surgery for large-angle esotropia secondary to Graves ophthalmopathy from 1995 to 2012 by a single surgeon at each of two institutions was performed. Patient characteristics, surgical technique, and pre- and postoperative measurements of ocular alignment were analyzed. A modified Gorman diplopia scale was used to assess outcome. Results: Of 38 patients, 36 had bilateral nonadjustable medial rectus recessions and lateral rectus resections as initial treatment for esotropia, and 6 patients underwent simultaneous vertical muscle surgery. Mean preoperative horizontal deviation was 60 Δ and mean preoperative vertical deviation was 10 Δ . Of the 38 patients, 19 (50%) reached the primary outcome, including 5 of 6 (85%) who had no preoperative vertical strabismus. The indications for reoperation were vertical strabismus in 13 of 21 patients (62%), residual esotropia in 7 of 21 (33%), and consecutive exotropia in 1 of 21 (5%). With a median follow-up of 13.2 months after first surgery, 32 of 38 patients (84%) reached the secondary outcome. Conclusions: Combining nonadjustable medial rectus recessions with lateral rectus resections can be a beneficial primary treatment for large-angle esotropia in patients with Graves ophthalmopathy, especially in those patients with small or no associated vertical strabismus.(Figure presented.)
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UR - http://www.scopus.com/inward/citedby.url?scp=85063866976&partnerID=8YFLogxK
U2 - 10.1016/j.jaapos.2018.08.013
DO - 10.1016/j.jaapos.2018.08.013
M3 - Article
VL - 23
SP - 15.e1-15.e5
JO - Journal of AAPOS
JF - Journal of AAPOS
SN - 1091-8531
IS - 1
ER -