title: Correction of restricted extraocular muscle motility in surgical management of strabismus in graves' ophthalmopathy.
abstract: OBJECTIVE
  To compare the success rates for strabismus surgery designed to correct limitation of duction with surgery designed to correct deviation in patients with Graves' ophthalmopathy.
  
  
  METHODS
  Retrospective nonrandomized comparative trial.
  
  
  METHODS
  One hundred thirty-seven patients with Graves' ophthalmopathy who had undergone at least one extraocular muscle surgery were divided into two groups: those whose first surgery occurred before June 1997 (control group) and those whose first surgery occurred in June 1997 or thereafter (case group).
  
  
  METHODS
  Extraocular muscle surgery primarily directed at either correcting deviation (control group) or correcting limitation of ductions (case group).
  
  
  METHODS
  Postoperative deviations in the primary position were measured in prism diopters 30 to 180 days after surgery. A postoperative deviation of less than 5 diopters was considered a successful surgical outcome.
  
  
  RESULTS
  Patients undergoing strabismus surgery specifically designed to correct limitation of duction achieved a 74% success rate compared with a 44% success rate in the control group (P < 0.01). Furthermore, the rate of reoperation in this group was only 27% compared with 44% in the control group (P < 0.04).
  
  
  CONCLUSIONS
  Compared with surgery aimed primarily at the correction of deviation, extraocular muscle surgery tailored to address restriction of ductions in patients with Graves' ophthalmopathy is associated with improved surgical success of initial realignment and with a lower rate of reoperation
authors.affiliation: University of Southern California School of Medicine, Los Angeles, California, USA.
authors.forename: Vu Thuy
authors.initials: VT
authors.lastname: Nguyen
authors.forename: Dong Jun John
authors.initials: DJ
authors.lastname: Park
authors.forename: Lori
authors.initials: L
authors.lastname: Levin
authors.forename: Steven E
authors.initials: SE
authors.lastname: Feldon
mesh_terms: D005133:Eye Movements; D005260:Female; D006111:Graves Disease / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013285:Strabismus / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome