Traditional three orbital wall decompression for severe thyroid-associated ophthalmopathy

Abstract

Objective To observe the clinical efficacy and safety of traditional three orbital wall decompression for patients with severe thyroid-associated ophthalmopathy. Methods Nine eyes of 6 patients with severe thyroid associated ophthalmopathy were collected. Whose exophthalmos were over 25 mm or orbital pressure were more than T+ 3, with exposed corneal ulcer and sharp decline of vision caused by optic nerve compression. They were treated with traditional three orbital wall decompression. The changes of vision, intraocular pressure, orbital pressure, degree of exophthalmos and proptosis, restrictions in eye movement, VEP, fundus clinical general appearance, CT results, diplopia, and complications were observed and compared before surgery, one week and three months after surgery. The clinical efficacy and safety of traditional three orbital wall decompression surgery for severe thyroid associated ophthalmopathy were evaluated. Results After the operation, the visual acuity was improved in six eyes, and remained unchanged in 3 eyes. The intraocular pressure decreased by 1-26 mmHg (1 mmHg=0.133 kPa) in seven eyes, and remained unchanged in 2 eyes. The recession of exophthalmos ranged from 4 mm to 9 mm, average (6.17±2.03)mm.The pressure within the orbit was reduced significantly in all cases. Corneal ulcers became better and the lagophthalmopathy was improved significantly. Post-operative general appearance was satisfactory in all subjects. Postoperative CT images showed good results of orbital pressure decompression. Conclusion For severe thyroid-associated ophthalmopathy, traditional three orbital wall decompression is effective and safe, as shown by our analysis using clinical indicators. It is safe and effective in the expansion of orbital volume validitiy, reduction in proptosis, improvement in appearance, and lowering orbital pressure. No serious complications were found. Key words: Ophthalmopathy, thyroid-associated, severe; Decompression, three orbital wall, traditional; Efficacy; Safety