Abstract：
OBJECTIVE: Strabismus reoperation in Graves\' ophthalmopathy (GO) is complicated and challenging. The purpose of this study was to evaluate the various surgical strategies of strabismus reoperation and their outcomes in patients with GO.
METHODS: A retrospective study was conducted on strabismus reoperations performed at the Zhongshan Ophthalmic Center of Sun Yat-sen University, Guangzhou, China from 2008 to 2018. Data collected included sex, age at surgery, duration of deviation, ocular alignment, ocular motility, various surgical procedures performed and surgical outcomes. Surgical methods included rectus recession for newly developed strabismus, rectus resection for undercorrection and anterior advancement of a previously recessed rectus for overcorrection. Surgical success was defined as an absence of diplopia, a horizontal deviation of ≤ 10 prism diopters (PD) and a vertical deviation of ≤ 5 PD at distance in primary and reading positions.
RESULTS: Of the 153 GO patients receiving strabismus surgery, 27 cases (20 males, 7 females) underwent reoperation for strabismus, with a reoperation rate of 17.6%. Success rates of reoperation in patients with a previous undercorrection and overcorrection were 45% and 71.4%, respectively. Success rates of rectus recession, rectus resection and anterior advancement were 47.1%, 66.7% and 50%, respectively. Two patients underwent the third surgery. The overall success rate was 51.9%.
CONCLUSIONS: Rectus recession is an effective method for GO patients with newly-developed strabismus. Rectus resection may benefit some patients with undercorrection who underwent a maximal degree of rectus recession. Anterior advancement of a previously recessed rectus is effective for cases with overcorrection.
METHODS: A retrospective study was conducted on strabismus reoperations performed at the Zhongshan Ophthalmic Center of Sun Yat-sen University, Guangzhou, China from 2008 to 2018. Data collected included sex, age at surgery, duration of deviation, ocular alignment, ocular motility, various surgical procedures performed and surgical outcomes. Surgical methods included rectus recession for newly developed strabismus, rectus resection for undercorrection and anterior advancement of a previously recessed rectus for overcorrection. Surgical success was defined as an absence of diplopia, a horizontal deviation of ≤ 10 prism diopters (PD) and a vertical deviation of ≤ 5 PD at distance in primary and reading positions.
RESULTS: Of the 153 GO patients receiving strabismus surgery, 27 cases (20 males, 7 females) underwent reoperation for strabismus, with a reoperation rate of 17.6%. Success rates of reoperation in patients with a previous undercorrection and overcorrection were 45% and 71.4%, respectively. Success rates of rectus recession, rectus resection and anterior advancement were 47.1%, 66.7% and 50%, respectively. Two patients underwent the third surgery. The overall success rate was 51.9%.
CONCLUSIONS: Rectus recession is an effective method for GO patients with newly-developed strabismus. Rectus resection may benefit some patients with undercorrection who underwent a maximal degree of rectus recession. Anterior advancement of a previously recessed rectus is effective for cases with overcorrection.
摘要：
目的：Graves眼病（GO）的斜视再手术复杂且具有挑战性。这项研究的目的是评估GO患者斜视再次手术的各种手术策略及其预后。
方法：对中山大学中山眼科中心的斜视再次手术进行了回顾性研究，广州,中国从2008年到2018年。收集的数据包括性别，手术年龄，偏差持续时间，眼对准,眼运动性,进行的各种外科手术和手术结果。手术方法包括新出现的斜视的直肌衰退，用于矫正不足的直肌切除术和用于过度矫正的先前凹陷的直肌的前移。手术成功被定义为没有复视，在主要和阅读位置的距离上，水平偏差≤10棱镜屈光度（PD），垂直偏差≤5PD。
结果：在153名接受斜视手术的GO患者中，27例（男性20例，7名女性）接受斜视再次手术，再次手术率为17.6%。先前矫正不足和矫正过度的患者的再次手术成功率分别为45％和71.4％，分别。直肌衰退的成功率，直肌切除和前推进占47.1%,66.7%和50%，分别。两名患者接受了第三次手术。总体成功率为51.9%。
结论：直肌衰退是治疗GO患者新发展的斜视的有效方法。直肌切除术可能会使一些矫正不足的患者受益，这些患者经历了最大程度的直肌衰退。先前凹陷的直肌的前移对于过度矫正的病例是有效的。
方法：对中山大学中山眼科中心的斜视再次手术进行了回顾性研究，广州,中国从2008年到2018年。收集的数据包括性别，手术年龄，偏差持续时间，眼对准,眼运动性,进行的各种外科手术和手术结果。手术方法包括新出现的斜视的直肌衰退，用于矫正不足的直肌切除术和用于过度矫正的先前凹陷的直肌的前移。手术成功被定义为没有复视，在主要和阅读位置的距离上，水平偏差≤10棱镜屈光度（PD），垂直偏差≤5PD。
结果：在153名接受斜视手术的GO患者中，27例（男性20例，7名女性）接受斜视再次手术，再次手术率为17.6%。先前矫正不足和矫正过度的患者的再次手术成功率分别为45％和71.4％，分别。直肌衰退的成功率，直肌切除和前推进占47.1%,66.7%和50%，分别。两名患者接受了第三次手术。总体成功率为51.9%。
结论：直肌衰退是治疗GO患者新发展的斜视的有效方法。直肌切除术可能会使一些矫正不足的患者受益，这些患者经历了最大程度的直肌衰退。先前凹陷的直肌的前移对于过度矫正的病例是有效的。
