The authors investigated patients with thyroid ophthalmopathy (TO) who underwent unilateral inferior rectus recession for hypotropia with or without adjustable sutures to determine extent of postoperative surgical alignment. Group A comprised 13 TO patients with inferior rectus recession with adjustable sutures. Group B comprised 14 TO patients with inferior rectus recession without adjustable sutures. Group C comprised 19 patients without TO undergoing recession with adjustable sutures. Group A responded differently to group C. Patients with TO had larger dose responses per mm of recession compared to controls with or without adjustable. TO patients had a drift back towards over correction. There was no significant difference between groups A and B.