Our Summary

This research analyzed the risk factors for patients with thyroid eye disease (TED) having to undergo a second strabismus surgery (eye alignment surgery). The study used a database of insurance claims to identify patients with TED who had at least one strabismus operation between 2003 and 2019. The researchers recorded which specific eye muscles were operated on, as well as the timing and frequency of any reoperations.

The study found that out of the 448 patients, around 25% needed a second operation. The results showed that the factor that most commonly led to patients needing a second operation was the number of eye muscles that were operated on in the first operation. The more muscles that were operated on initially, the more likely a patient was to need a second operation and the shorter the time was to that second operation.

Other factors such as the patient’s age at the time of the first surgery, the time between being diagnosed with TED and the first surgery, the patient’s gender, race, and whether adjustable sutures were used in the operation did not affect the time to the second operation.

FAQs

  1. What were the main findings of the study on risk factors for a second strabismus surgery in patients with thyroid eye disease (TED)?
  2. Does the patient’s age, gender, or race impact the likelihood of needing a second strabismus surgery according to the study?
  3. How does the number of eye muscles operated on in the first surgery affect the need for a second operation?

Doctor’s Tip

One helpful tip a doctor might tell a patient about strabismus surgery is to discuss with them the importance of limiting the number of eye muscles operated on during the initial surgery. This study suggests that operating on fewer muscles may reduce the likelihood of needing a second operation in the future. It is important for the doctor and patient to have a thorough discussion about the potential risks and benefits of the surgery, as well as the likelihood of needing additional procedures.

Suitable For

Overall, patients with thyroid eye disease who undergo strabismus surgery are at risk for needing a second operation if multiple eye muscles are operated on in the initial surgery. It is important for healthcare providers to consider this risk when recommending strabismus surgery for patients with TED.

Timeline

Before strabismus surgery, patients typically experience symptoms such as double vision, eye misalignment, eye strain, headaches, and difficulty focusing. They may undergo a comprehensive eye examination, including tests to measure visual acuity, eye alignment, and eye movement. The ophthalmologist will determine the best treatment plan, which may include glasses, vision therapy, or surgery.

After strabismus surgery, patients may experience some discomfort, redness, and swelling in the eye area. They may need to wear an eye patch for a few days and use prescribed eye drops to prevent infection and promote healing. Follow-up appointments with the ophthalmologist are crucial to monitor progress and make any necessary adjustments to the treatment plan. It may take a few weeks for the eyes to align properly, and vision may continue to improve over time. In some cases, patients may need additional surgeries or follow-up treatments to achieve the desired results.

What to Ask Your Doctor

Some questions a patient should ask their doctor about strabismus surgery include:

  1. What are the potential risks and complications associated with strabismus surgery?
  2. What is the success rate of strabismus surgery in improving eye alignment?
  3. How long is the recovery period after strabismus surgery and what can I expect during this time?
  4. Will I need to wear an eye patch or use eye drops after the surgery?
  5. How many eye muscles will be operated on during the surgery and how does this affect the likelihood of needing a second operation?
  6. What factors may increase the likelihood of needing a second strabismus surgery in the future?
  7. Are there any alternative treatments or therapies that could be considered before opting for surgery?
  8. What is the experience of the surgeon performing the strabismus surgery and how many similar procedures have they performed?
  9. Will I need to follow up with regular appointments after the surgery to monitor my progress?
  10. What are the expected long-term outcomes of strabismus surgery for my specific condition?

Reference

Authors: Hwang B, Heo H, Lambert SR. Journal: Am J Ophthalmol. 2022 Jun;238:10-15. doi: 10.1016/j.ajo.2021.11.022. Epub 2021 Nov 27. PMID: 34843685