Free levator complex recession in Graves' ophthalmopathy. Our experience

The use of scleral graft has been suggested in patients with upper lid retraction due to thyroid ophthalmopathy to correct severe cases and to avoid unpredictable results. But this technique is more complicated than others and more time-consuming. The authors have used a free recession technique to deal with the functional and cosmetic problems of these patients. The results of a group of 60 patients (98 eyes) with Graves' ophthalmopathy who were referred to their institute over the last ten years and underwent eyelid surgery were evaluated. Free recession surgery achieved good results in 75% of all cases after one procedure. In spite of careful preoperative evaluation the remaining patients needed additional surgery to achieve a good final result. However, in some cases the outcome of the surgery in upper lid retraction remains unpredictable.