IRMPT for strabismus repair in TED results in durable relief of diplopia

Intraoperative relaxed muscle positioning technique (IRMPT) for strabismus repair in thyroid eye disease (TED) results in durable relief of diplopia in a large majority of patients, according to a study presented at ARVO 2023. However, patients with greater horizontal deviations, disease reactivation, and prior interventions were more likely to require re-operations.

The findings of this study have important implications for the treatment of TED-related strabismus. The IRMPT technique appears to be a promising approach for improving outcomes and reducing the need for re-operations. However, further research is needed to confirm these findings and optimize the use of this technique in clinical practice.

The IRMPT involves recessing restricted muscles’ insertions to positions on the globe where they rest without tension.

The study reviewed the charts of 129 patients with TED and diplopia who underwent IRMPT between 1999 and 2021. Demographic characteristics, initial surgical outcomes, reoperation outcomes, and those at last follow-up were evaluated.

The results showed that 96 (73.8%) patients underwent one surgery, while 33 (26.2%) required a second procedure. Of the 29 patients who underwent Bilateral Inferior Rectus and Medial Rectus Recession, 9 required a second procedure, of whom 2 had a third procedure. An excellent outcome was noted in 22 (73.3%) patients, while 4 (13.3%) had a good outcome. Of the 23 Unilateral Inferior Rectus Recessions only 6 required a second procedure. An excellent outcome was noted in 18 (78.3%) and 4 (21.7%) had a good outcome. Overall, 121 (93.8%) patients experienced good or excellent results (Excellent, 76.7% and good, 12.7%).

Reference
Muste J, et al. Long Term Outcomes of the Intraoperative Relaxed Muscle Positioning Technique of Strabismus Surgery in Thyroid Eye Disease. Presented at: ARVO 2023.