Our results pooled with those of others demonstrate a statistically significant improvement in outcome when adjustable sutures are implemented in the treatment of thyroid ocular myopathy. To our knowledge, this degree of significance has not been reported previously. We believe the value of adjustable suture strabismus surgery lies mainly in the prevention of large undercorrections and overcorrections. However, one cannot guarantee fusion or long-term alignment stability, especially without prism use. A randomized, prospective, controlled study to compare the nonadjustable and adjustable techniques for the treatment of thyroid ocular myopathy has yet to be performed. The success of any type of strabismus surgery relies on many factors. Future endeavors should implement the quantified adjustable suture technique to better define how preoperative conditions influence the response to strabismus surgery in Graves' patients.
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