J Korean Ophthalmol Soc > Volume 56(4); 2015 > Article
Journal of the Korean Ophthalmological Society 2015;56(4):573-579.
DOI: https://doi.org/10.3341/jkos.2015.56.4.573    Published online April 15, 2015.
Evaluation of Prognostic Factors and Outcomes of Single-Stage Adjustable Strabismus Surgery in Thyroid Eye Disease.
Hyun Ju Park, Jong Bok Lee, Jin Sook Yoon, Soolienah Rhiu
1Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
2Department of Ophthalmology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea. soolienah99@naver.com
갑상선 안병증 환자에서 점안 마취하 수술 중 조정사시수술의 효과와 예후 인자에 대한 평가
박현주1⋅이종복1⋅윤진숙1⋅유수리나2
연세대학교 의과대학 안과학교실1, 한림대학교 의과대학 동탄성심병원 안과학교실2
Abstract
PURPOSE
To evaluate the prognostic factors that contribute to favorable surgical outcomes of single-stage adjustable strabismus surgery in thyroid eye disease. METHODS: Retrospective review of clinical case notes were done of all patients who had surgical treatment for strabismus related to thyroid eye disease under the care of a single hospital between January 2005 and December 2012 (n = 30). Factors that possibly influenced the outcome were statistically analyzed for significance. "Successful" surgical outcome was defined as patients whose residual deviation was within 8 prism diopters and free from diplopia in the primary position on postoperative 1 year. RESULTS: Mean preoperative vertical deviation was 17.5 prism diopters (PD) and horizontal deviation was 20.3 PD. Mean follow-up time was 12.4 months. Twenty-four patients (80.0%) had successful surgical results. Four patients (13.3%) needed further surgery due to recurrence of previous strabismus and two patients (6.7%) needed prism glasses due to remaining strabismus. Previous history of proptosis (p = 0.02), optic neuropathy (p = 0.01), intravenous (IV) steroid pulse therapy (p = 0.02), number of times of IV steroid pulse therapy (p = 0.01), and orbital decompression surgery (p = 0.03) were different between success and failure groups. CONCLUSIONS: Single-stage adjustable strabismus surgery under topical anesthesia showed a success rate of 80% for strabismus patients with thyroid eye disease. Patients who previously had proptosis, optic neuropathy, IV steroid pulse therapy, and orbital decompression surgery significantly showed unsuccessful results after strabismus surgery.
Key Words: Adjustable strabismus surgery;Thyroid eye disease


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