Vertical rectus muscle recession versus combined vertical and horizontal rectus muscle recession in patients with thyroid eye disease and hypotropia. Cestari, D. M., Freire, M. V., & Chun, B. Y. Journal of AAPOS: the official publication of the American Association for Pediatric Ophthalmology and Strabismus, July, 2018.
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PURPOSE: To compare the postoperative vertical drift in patients with thyroid eye disease (TED) with hypotropia who underwent vertical rectus recession alone versus recession combined with horizontal rectus recession. METHODS: The medical records of patients with TED who underwent strabismus surgery for hypotropia between 2006 and 2015 were reviewed retrospectively. Patients were divided into two groups: group 1 underwent vertical rectus recession only; group 2 underwent vertical rectus recession plus horizontal rectus recession. Data collection included pre- and postoperative deviation measurements and amount of surgical recession performed. The amount of postoperative vertical drift between groups was compared. RESULTS: Of 67 patients who underwent surgery during the study period, 18 met inclusion criteria, 9 in each group. Mean postoperative hypotropia was 24.2Δ in group 1 and 24.5Δ in group 2 (P = 0.82). Mean vertical deviations were 0.3Δ and -2.2Δ (P = 0.134) on postoperative day 1 -0.9Δ and -8.0Δ (P = 0.043) at final follow-up for groups 1 and 2. Mean postoperative vertical drift toward hypertropia was 1.2Δ in group 1 and 6.8Δ in group 2 (P = 0.048). The surgical success rate for group 1 was superior to that for group 2 (89% vs 67% [P = 0.024]). CONCLUSIONS: There was a significantly larger postoperative vertical drift in TED patients with hypotropia who had combined vertical rectus and horizontal rectus recessions compared with those who underwent vertical rectus recession alone.
@article{cestari_vertical_2018,
	title = {Vertical rectus muscle recession versus combined vertical and horizontal rectus muscle recession in patients with thyroid eye disease and hypotropia},
	issn = {1528-3933},
	doi = {10.1016/j.jaapos.2018.04.007},
	abstract = {PURPOSE: To compare the postoperative vertical drift in patients with thyroid eye disease (TED) with hypotropia who underwent vertical rectus recession alone versus recession combined with horizontal rectus recession.
METHODS: The medical records of patients with TED who underwent strabismus surgery for hypotropia between 2006 and 2015 were reviewed retrospectively. Patients were divided into two groups: group 1 underwent vertical rectus recession only; group 2 underwent vertical rectus recession plus horizontal rectus recession. Data collection included pre- and postoperative deviation measurements and amount of surgical recession performed. The amount of postoperative vertical drift between groups was compared.
RESULTS: Of 67 patients who underwent surgery during the study period, 18 met inclusion criteria, 9 in each group. Mean postoperative hypotropia was 24.2Δ in group 1 and 24.5Δ in group 2 (P = 0.82). Mean vertical deviations were 0.3Δ and -2.2Δ (P = 0.134) on postoperative day 1 -0.9Δ and -8.0Δ (P = 0.043) at final follow-up for groups 1 and 2. Mean postoperative vertical drift toward hypertropia was 1.2Δ in group 1 and 6.8Δ in group 2 (P = 0.048). The surgical success rate for group 1 was superior to that for group 2 (89\% vs 67\% [P = 0.024]).
CONCLUSIONS: There was a significantly larger postoperative vertical drift in TED patients with hypotropia who had combined vertical rectus and horizontal rectus recessions compared with those who underwent vertical rectus recession alone.},
	language = {eng},
	journal = {Journal of AAPOS: the official publication of the American Association for Pediatric Ophthalmology and Strabismus},
	author = {Cestari, Dean M. and Freire, Marcelle V. and Chun, Bo Young},
	month = jul,
	year = {2018},
	pmid = {30031873}
}

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