Nonadjustable strabismus surgery for restrictive thyroid eye disease

We evaluated the results of nonadjustable strabismus surgery in patients with restrictive thyroid eye disease without and after 3-wall orbital decompression. Sixteen patients had primary extraocular muscle surgery (group 1) and 19 patients needed first 3-wall orbital decompression (group 2). The most affected muscles were recessed and sometimes the contralateral overacting inferior oblique was disinserted. In group 1 fourteen patients (87,5%) were entirely free of diplopia after one operation, 1 patient (6.25%) had binocular single vision with a small prism and 1 (6.25%) needed a re-operation. In group 2 eleven patients (57.9%) were free of diplopia, 1 (5.25%) had diplopia in extreme gaze directions, 1 (5.25%) was corrected with a prism and 6 patients (31.6%) were re-operated. Nonadjustable strabismus surgery gives good functional results in patients with restrictive thyroid eye disease. Three-wall orbital decompression with combined ocular motility disturbances increases the re-operation rate.