Bilateral inferior rectus muscle recession for correction of hypotropia indysthyroid ophthalmopathy

Purpose: The restrictive myopathy of dysthyroid ophthalmopathy frequently r esults in strabismus and diplopia. The most common deviation is hypotropia. Ipsilateral inferior rectus muscle recession, the generally accepted treat ment, may lead to a progressive marked overcorrection. The purpose of this study is to evaluate the results of bilateral asymmetric inferior rectus mu scle operations with regard to late progressive overcorrection. Methods:A r etrospective review of all patients undergoing bilateral inferior rectus mu scle recession for dysthyroid ophthalmopathy between 1993 and 1997 found 8 patients with hypotropia resulting from dysthyroid ophthalmopathy. Alignmen t and motility were assessed preoperatively and postoperatively in all pati ents. Bilateral asymmetric inferior rectus muscle recession was performed o n all patients with an adjustable suture performed on the hypotropic eye. A successful, long-term, postoperative result was defined as orthophoria or a vertical misalignment of less than or equal to 5 PD in primary gaze. Resu lts: Data were collected from 8 patients at 4 to 6 weeks postoperatively. S ix patients had successful alignment, and 2 patients remained undercorrecte d. Seven patients were successfully aligned, and 1 patient was undercorrect ed at the latest postoperative examination (mean, 18 months). Conclusion: I n our series, bilateral asymmetric inferior rectus muscle recession resulte d in successful correction of hypotropia without late postoperative overcor rections in patients with dysthyroid ophthalmopathy.