Outcomes of Strabismus Surgery Following Teprotumumab Therapy

To investigate the results of patients undergoing surgical treatment for strabismic diplopia in thyroid eye disease (TED) following teprotumumab. Multicenter, retrospective, case series. We report 28 patients who underwent extraocular muscle surgery for strabismic diplopia after treatment with tepro...

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Bibliographic Details
Published in:American journal of ophthalmology 2024-06, Vol.262, p.186-191
Main Authors: Hilliard, Grant, Pruett, Jaron, Donahue, Sean P., Velez, Federico G., Peragallo, Jason H., Ditta, Lauren C., Tavakoli, Mehdi, Hoehn, Mary E., Kuo, Annie F., Indaram, Maanasa, Kerr, Natalie C.
Format: Article
Language:English
Subjects:
Adult
Aged
Antibodies, Monoclonal, Humanized - therapeutic use
Decompression, Surgical
Diplopia - physiopathology
Female
Graves Ophthalmopathy - drug therapy
Graves Ophthalmopathy - surgery
Humans
Male
Middle Aged
Oculomotor Muscles - physiopathology
Oculomotor Muscles - surgery
Ophthalmologic Surgical Procedures
Retrospective Studies
Strabismus - physiopathology
Strabismus - surgery
Treatment Outcome
Vision, Binocular - physiology
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Summary:To investigate the results of patients undergoing surgical treatment for strabismic diplopia in thyroid eye disease (TED) following teprotumumab. Multicenter, retrospective, case series. We report 28 patients who underwent extraocular muscle surgery for strabismic diplopia after treatment with teprotumumab at 7 different academic centers. Elapsed time from last teprotumumab dose to the date of surgery, previous orbital decompression, primary preoperative horizontal and vertical deviation, surgical procedure, and 2-month postoperative results were collected from the patient records. Sixteen (57%) patients were diplopia-free after 1 surgery. Three (11%) chose prism spectacles to correct residual diplopia, 2 (7%) used compensatory head posture to resolve diplopia, and 1 (4%) had intermittent diplopia and was functionally improved (choosing no prisms or further surgery). These were considered treatment successes. Three (11%) patients required reoperation, and all were diplopia-free after their second procedure. Most patients requiring surgery for strabismic diplopia following teprotumumab achieve good outcomes with success rates comparable to series published before the availability of teprotumumab.
ISSN:0002-9394
1879-1891
1879-1891
DOI:10.1016/j.ajo.2024.01.005