Study: Outcome of One-to-Four Muscle Surgery by Intraoperati
A Study was conducted to identify the outcome of one-to-four muscle surgery by intraoperative relaxed muscle positioning with adjustable suture technique for the treatment of thyroid eye disease.

90 patients diagnosed with thyroid eye disease who underwent intraoperative relaxed muscle positioning with adjustable suture technique were included in this retrospective study. Successful outcomes were categorized into two parts: motor outcome and sensory outcome. Successful motor outcome was defined as vertical deviation equal to 4 prism diopters or less and horizontal deviation equal to 10 prism diopters or less in primary position.

--90 patients were included in this study, and the mean age of strabismic surgery was 56.6 ± 10.1 years old. 39 patients had a history of orbital decompression surgery.

--The success of motor and sensory outcomes exhibited a decrease from one-to-four muscle surgery.

--Motor success decreased from one-muscle to four-muscle surgery and sensory success similarly decreased. However, the comparative outcomes of motor success and sensory success were not statistically different among groups. Lower lid retractions were found in 12 patients (13.33%).

Finally, the intraoperative relaxed muscle positioning approach may be a viable choice for the treatment of strabismus caused by thyroid eye illness. One-to-four muscle surgery can be used to perform this procedure, which results in successful motor and sensory outcomes.