Postoperative shift in ocular alignment following single vertical rectus recession on adjustable suture in adults without thyroid eye disease

Purpose To determine whether overcorrection shifts occur after vertical rectus recession on adjustable suture in the absence of thyroid eye disease. Methods The medical records of patients without thyroid eye disease who underwent vertical rectus recession surgery from 2001 to 2008 were retrospectively reviewed for shifts in alignment between suture adjustment at postoperative day 1 and 2 months' follow-up. Superior rectus and inferior rectus recessions were compared. In addition, we compared the use of a nonabsorbable polyester suture to an absorbable polyglactin 910 suture in nonthyroid patients undergoing inferior rectus recessions. Results A total of 59 patients were included (superior rectus, 30; inferior rectus, 29). We found a mean undercorrection shift of 1.1 (range, 17.5^Δ undercorrection to 16^Δ overcorrection) and 1.0^Δ (range, 12^Δ undercorrection shift to 6^Δ overcorrection shift) for superior and inferior rectus recessions, respectively, between 1 day and 2 months postoperatively. Conclusions There was no trend toward overcorrection following unilateral vertical rectus adjustable suture recessions in patients without thyroid eye disease, suggesting that thyroid myopathy may account for overcorrection shifts seen with this surgery.