Abstract
AimThe purpose of this study is to share our experience on the use of different orbital decompression techniques, as well as the principles followed for deciding the most case-appropriate procedure that ensured the most favorable outcomes.MethodsWe reviewed the Graves’ ophthalmopathy cases operated over the course of 14 years, regarding the presenting signs, the imaging evaluation, the degree of exophthalmos, the type of surgical orbital decompression performed, and the postoperative outcomes.ResultsAll 42 patients identified presented with proptosis, with 92.8% cases of bilateral proptosis. The main addressing concern was functional in 54.8% cases and aesthetic in 45.2% patients. CT was used for the preoperative evaluation in all cases. In total, 81 orbits were operated. The orbital decompression surgery involved only the orbital fat in 7.4% of orbits and associated fat and bone decompression in the other 92.6% of orbits. The postoperative results were favorable in all cases regarding both appearance and function, with minimal postoperative complications.ConclusionThe adequate selection of the most suitable procedure based on the characteristics of each case is the prerequisite for a successful surgery. We found that the association of fat and bone decompression of various extents is most permissive in tailoring the degree of decompression to the existing requirements.
Highlights
Almost half of patients with Graves’ disease develop ophthalmopathy [1, 2]
All patients presented with proptosis, showing globe projection measurements between 22 and 31 mm
Globe projection was measured clinically during the ophthalmologic evaluation, by using Hertel’s exophthalmometer, and confirmed by measurements performed on the CT images
Summary
Almost half of patients with Graves’ disease develop ophthalmopathy [1, 2] Their life quality is greatly impacted by the developing orbital and periorbital changes. The associated exophthalmos, double vision, retraction of the eyelids, periorbital edema, strabismus, and optic neuropathy determine aesthetic and functional disturbances to various degrees. Addressing these modifications is compelling in order to improve the psycho-social life of the patients. Surgery follows an initial unsuccessful medical treatment and is usually indicated in the inactive stage of the disease. It is Camelia Bogdanici and Cristina Preda contributed to this work
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