Recession of the inferior rectus muscle in Graves’ orbitopathy

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Abstract
To identify the predictive factors for overcorrection and depression impairment after recession of the inferior rectus muscle (IRM) in patients with Graves’ orbitopathy. Retrospective cohort study, single institution. The charts of 124 consecutive patients who underwent recession of the IRM were retrospectively examined, as well as all literature with regard to the subject until January 2008. Ductions measurements, computed tomography (CT) appearance, proptosis, NOSPECS-scores, duration of thyroid disease, duration of orbitopathy, previous treatment of Graves’ thyroid disease and orbitopathy, extent of recession, age, gender, diabetes, smoking, and use of immunosuppressants were all evaluated for prognostic significance. Duration and severity of orbitopathy and impaired contralateral elevation were significant prognostic factors for overcorrection. Increase of volume of the ipsilateral superior rectus muscle was an independent risk factor for both overcorrection and limitation of depression. An increase in volume of the ipsilateral superior rectus muscle should be considered when determining the extent of recession of the IRM.

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