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The results of extraocular muscle surgery in 22 patients with Graves' ophthalmopathy were evaluated. All patients were classified in NOSPECS class 4. The mean age at the time of squint surgery was 55(10)/12 years; there were 6 males and 16 females. Ten patients had primary extraocular muscle surgery. Twelve patients were first treated with prednisone alone or prednisone and retrobulbar irradiation therapy (1000 RAD) and orbital decompression because of other ocular symptoms. All patients were euthyreotic at the time of operation, and their motility was unchanged for at least 6 months. Altogether 40 muscles were operated; most often recession of the inferior rectus (11 X) and recession of the medial rectus (9 X) were performed. All patients achieved orthophoria and a useful field of binocular single vision postoperatively.
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