Surgical treatment of endocrine exophthalmos by removal of orbital fat: clinical experience

Abstract

PURPOSE:To report a series of 73 patients with endocrine exophthalmos treated by removal of orbital fat using the transpalpebral approach during the period 1989 to 1999. METHODS:The operation was performed according to the technique described by Olivari. Aesthetic analysis was done preoperatively and postoperatively (more than 6 months after surgery). The number of complications was also observed. RESULTS:The average volume of resected fat was approximately 7.6 mL per orbit. No major complication was observed. In 9 patients with epiphora, all improved. One patient developed postoperative diplopia and 5 complained of temporary diplopia. Appearance improved in 62 patients (85%).CONCLUSION: Surgical removal of orbital fat associated with endocrine exophthalmos provides consistent improvement in appearance with a low rate of complications. Additional procedures may be indicated to improve the cosmetic outcome.

En bloc resection of the lateral orbital rim to reduce exophthalmos in patients with Graves' disease

“…Therefore, this analysis included Naugle exophthalmometer readings only. Another surgical technique is the removal of intraorbital fat through a transpalpebral incision, which was reported to have a lower postoperative complication rate (Olivari, 1991;Stark and Olivari, 1993;Ferreira et al, 2002) and a mean globe recession of 5.9 mm in 108 eyes (Olivari, 1991).…”

Transpalpebral Decompression of Endocrine Ophthalmopathy by Intraorbital Fat Removal (Olivari Technique): Experience and Progression after More than 3000 Operations over 20 Years

“…The promising and satisfying results demonstrated by Olivari earliest in 1988 have been confirmed in further evaluations at our institution and others. 5,22,28,29,42,[45][46][47][48][49] In summary, this technique, which is associated with very low morbidity, is our method of choice in moderate to severe cases of exophthalmos and in functionally asymptomatic patients with mild to moderate aesthetic impairment. However, it has to be emphasized that this complex and multifactorial disorder often requires a wide longterm medical attendance in terms of multiple adjusting modifications depending on individual requirements and tissue characteristics.…”

Critical Appraisal on Orbital Decompression for Thyroid Eye Disease: A Systematic Review and Literature Search

“…Removal of the medial wall is indicated for relief of optic nerve compression in cases of DON and is better performed via transcaruncular or endoscopic approach [ 72 , 73 , 85 ]. Removal of periocular fat may alleviate the intraorbital pressure and is even effective in cases of DON [ 27 , 72 , 79 , 80 , 82 ]. In clinical practice, the techniques for removal of medial and lateral wall are often used in combination with or without endoscopic assistance and their result is augmented by additional fat removal [ 21 , 72 , 86 – 88 ].…”