ASOPRSFall Scientific SymposiumSyllabus
144
Patterns of Strabismus FollowingOrbital Decompression inThyroidEyeDisease, continued
DetailedProgram
—Friday,October 17, 2014
Canwedobetter?
•
10-60% isahuge range
•
What kindof doublevision is it?
•
Is it possible toexamine topredictwhichpatients
will get doublevisionafter orbital
decompression?
•
Canwepredict thepatternof diplopiapatients
will developbaseduppreoperativedata?
Objective
•
Toqualify further thepatterns of strabismus
that occur followingorbital decompression for
thyroideyedisease
Methods
•
Consecutive, clinical followup studyof all
patientsundergoingorbital decompression for
TED
•
July2009–December 2012
•
Exclusioncriteria:
–
Previous orbital or strabismus surgery
–
Insufficient followup/chart data
•
Followed from timeof orbital decompression toat
least 6months followingdecompression
Results
•
113patient charts reviewed
–
17patient excluded
–
96patients (169orbits) enrolled
–
71 female, 25male
TABLE 2.DescriptiveCharacteristics ofParticipantsbySubject
Variables
Post Decompression Strabismus
Comitant
(subjects,
n=33)
Incomitant
(subjects,
n=30)
P-
Value*
No Strabismus
(subjects,
n=33)
P-
Value**
Mean±SD
Mean±SD
Mean±SD
Age, years
56.4±13.9
52.7±13.1
0.28
47.0±13.6
0.01
Clinical Activity Score
2.7±2.2
2.5±2.4
0.77
2.2±1.1
0.40
Time toDecompression
6.1±7.3
5.2±6.3
0.67
8.2±7.0
0.18
N(%)
N(%)
N(%)
Gender:
Female
Male
25(76)
8(24)
18(60)
12(40)
0.18
28(85)
5(15)
0.08
Ethnicity:
European Descent
African Descent &Other
28(85)
5(15)
26(87)
4(13)
0.84
20(61)
13(39)
0.005
Pre-Decompression Diplopia
9(28)
13(45) 0.18
n/a
Pre-Decompression Radiation
18(72)
13(54) 0.20
14(64)
0.98
Botox at Decompression
4(13)
5(19)
0.59
n/a
Clinical Activity Score <4
27(82)
23(77) 0.61
27(82)
0.77
Straight Post Strabismus Surgery
25(78)
17(59)
0.1
n/a
Comitant Pre-Decompression
3(30)
3(21)
0.63
n/a
Walls Decompressed
1 or 2
3 or 4
8(14)
50(86)
18(34)
35(66)
0.012
26(23)
85(77)
<0.001
** Comitant vs Incomitant
**Strabismus vs No Strabismus
TABLE1.DescriptiveCharacteristics of Participants byEye
Variables
Post-Decompression Strabismus
Comitant
(eyes, n=65)
Incomitant
(eyes, n=60)
P-
value*
No Strabismus
(eyes, n=66)
P-
value**
Mean±SD
Mean±SD
Mean±SD
Pre-DecompressionMedial Rectusmuscle
, mm
59.5±17.0
57.6±18.6
0.62
46.8±16.7
<0.001
Pre-Decompression Lateral Rectusmuscle
,mm
43.2±13.3
40.2±13.2
0.29
35.4±9.1
0.002
Pre-Decompression Superior Rectus Complex
muscle
, mm
59.6±15.1
62.0±19.2
0.50
49.9±14.8
<0.001
Pre-Decompression Inferior Rectusmuscle
,mm
62.9±2.4
63.3±20.6
0.93
54.1±23.3
0.01
Pre-DecompressionMargin To ReflexDistance 1
6.0±2.1
5.7±1.8
0.47
5.5±1.8
0.19
Pre-DecompressionMargin To ReflexDistance 2
6.7±1.7
6.4±1.3
0.43
6.7±1.4
0.44
Pre-Decompression Lag
0.5±1.2
0.9±1.2
0.19
0.6±0.9
0.62
Pre-Decompression Naugle
23.2±3.5
23.2±3.0
0.92
23.9±2.7
0.16
Post-Decompression ABDUCTION
-1.1±0.9
-1.3±1.1
0.14
-0.08±0.3
<0.001
Post-Decompression ADDUCTION
-0.11±0.4
-0.14±0.4
0.64
0.0±0.0
0.006
Post-Decompression SUPRADUCTION
-1.2±1.1
-0.9±1.1
0.18
-0.06±0.4
<0.001
Post-Decompression INFRADUCTION
-0.2±0.5
-0.09±0.3
0.30
-0.02±0.09
0.03
Post-DecompressionMargin To ReflexDistance 1
5.3±1.9
4.6±1.4
0.03
4.3±1.3
0.004
Post-DecompressionMargin To ReflexDistance 2
5.7±1.5
5.5±1.5
0.59
5.0±1.7
0.39
Post-Decompression Lag
0.7±1.5
1.5±2.4
0.051
1.4±2.3
0.29
Post-Decompression Naugle
19.1±2.8
19.5±2.8
0.42
19.5±2.8
0.58
* Comitant vs Incomitant
**Strabismus vs No Strabismus
