Esotropia following bilateral lateral orbital decompressions for Graves' disease.
A 48-year-old woman with mild Graves' orbitopathy underwent bilateral lateral orbital decompressions through preauricular hairline incisions by a general plastic surgeon. Immediately postoperatively she developed marked left orbital and eyelid edema and incapacitating diplopia due to a large angle esotropia and severe bilateral abduction deficits. Examination 13 months later revealed normal visual acuities and a 90 prism diopter esotropia. She underwent complex strabismus surgery with resultant orthophoria in primary and down gaze. Four years later, a thin section computed tomographic scan revealed severe attenuation of both lateral rectus muscles with incarceration of the muscle bellies into the lateral osteotomy sites. This case demonstrates a rare, but avoidable, complication of orbital surgery for Graves' disease.
Goldberg
S H
SH
Department of Ophthalmology, Penn State University College of Medicine, Hershey.
Bullock
J D
JD
Guyton
D L
DL
D004948:Esotropia / Q000209:etiology*; D005260:Female; D006111:Graves Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009915:Orbit / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications; D011859:Radiography