Aim: Inferior rectus recession (IRR) surgery has been reported to be unstable, and there have been particular concerns about progressive overcorrection. This study reviewed the vertical outcomes following IRR surgery in order to observe postoperative stability.
Methods: A retrospective review is presented of all IRR surgery by a single surgeon from January 1996 to March 2006.
Results: A total of 42 cases were included, with adjustable sutures being used in 40. The mean follow-up was 9 months. The mean (median) pre-operative vertical deviation in the primary position was 19.8Δ(20Δ) pre-operatively, reducing to 5.2Δ (2Δ) at the final post-operative visit. The aim of a small undercorrection within the patient’s vertical fusion range was achieved in all cases, after adjustment if necessary. By the end of follow-up, 35 (83%) patients retained a satisfactory result, 5 (12%) were overcorrected and 2 (5%) were undercorrected. Twenty-five (60%) remained orthophoric or undercorrected, while 17 (40%) progressed from a planned undercorrection to an overcorrection. Overcorrection was significantly more common in thyroid eye disease (TED) patients (12/20) than the non-TED patients (5/22) (p = 0.014, chi-square). Three patients (7%) demonstrated progressive overcorrection, all of whom had TF.D.
Conclusion: In this study, aiming for a small undercorrection within the patient’s vertical fusion range allowed for resolution of symptoms in most cases. TED was more susceptible to overcorrection. Progressive overcorrection did occur, but was uncommon.