An Individualized Approach to Orbital Decompression in Graves' Orbitopathy

Hurwitz, Jeffrey J.; Birt, Derek

doi:10.1001/archopht.1985.01050050052016

Cited by 60 publications

(19 citation statements)

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“…In another large study of 305 patients, 23% needed eye muscle surgery, but diplopia was corrected by prisms in other patients (Warren et al 1989). In other smaller studies the frequency of postoperative diplopia was between 18 and 85% (Grahne et al 1985;Shorr et al 1982;Lyons & Rootman 1994;Hurwitz & Birt 1985).…”

Section: Discussioncontrasting

confidence: 41%

Results of transantral orbital decompression in patients with thyroid‐associated ophthalmopathy

Tallstedt

Papatziamos²,

Lundblad³

et al. 2000

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To present the results of orbital decompression in patients with thyroid-associated ophthalmopathy (TAO). Methods: Transantral orbital decompression was performed in 63 patients with TAO. In 40 patients (63%) the operation was made because of progressive ophthalmopathy not responding to medical therapy, and in 23 patients (37%) the operation was made for rehabilitative reasons. The long-term hypesthesia engaging the infraorbital nerve was assessed with a questionnaire using a Visual Analogue Scale (VAS). Results: The mean proptosis reduction was 3.2 mm (range 0-8 mm). Twentyone patients had impaired visual acuity preoperatively, and 20 improved. Altogether 30 patients (40%) had worsened ocular motility postoperatively. Fortythree patients did not have diplopia in the primary position preoperatively, and new diplopia developed in 22 of these (51%). Hypesthesia in the infraorbital nerve area was reported for half of the operated sides, but was a major cause of distress (VAS-scoring ±5) to eleven patients. Conclusions: Transantral orbital decompression is indicated in patients with progressive TAO or in patients with prominent exophthalmos, and results in a good proptosis reduction, but the risk of postoperative diplopia is significant. Postoperative hypesthesia is common but often not a major problem.

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Section: Discussioncontrasting

confidence: 41%

Results of transantral orbital decompression in patients with thyroid‐associated ophthalmopathy

Tallstedt

Papatziamos²,

Lundblad³

et al. 2000

Acta Ophthalmologica Scandinavica

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“…A three-wall decompression is likely to give a better reduction of the proptosis and to cause less muscle imbalance. A reasonable approach would be a graded decompression, as has been advocated by some authors (18,28,43). In patients with minor proptosis, orbital fat removal or maybe a lateral decompression might be sufficient, and in patients with more pronounced exophthalmos, a bone decompression of two, three, or maybe four walls is more adequate.…”

Section: Eyelid Surgerysupporting

confidence: 38%

Surgical Treatment of Thyroid Eye Disease

Tallstedt¹

1998

Thyroid

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Thyroid eye disease may result in exophthalmos, diplopia, and eyelid malpositions, which can be corrected with different surgical procedures. Several techniques for decompressing the orbit have been described, and the advantages and disadvantages of the techniques are discussed. Our own results of the transantral approach are briefly summarized. Eye muscle surgery should be performed after an orbital decompression, and it is not unlikely that more than one muscle operation will be needed in order to achieve single vision. A number of operative procedures for eyelid surgery have been described, and the results of the various methods are generally good.

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“…Deep lateral wall decompression removes bone posterior to the muscle cone, inducing less shift [113,126,127]. Goldberg et al [113] suggested removal from three areas: the lacrimal keyhole, the basin of the inferior orbital fissure, and the sphenoid marrow-filled door jamb, which is the most voluminous [110,111•,112,113,115•,128].…”

Section: Orbital Decompressionmentioning

confidence: 43%