Decompression for dysthyroid ophthalmopathy via the orbital rim approach

Elisevich, Kost; Allen, Larry H.; Bite, Uldis; Colcleugh, Robert G.

doi:10.3171/jns.1994.80.3.0580

Cited by 10 publications

(5 citation statements)

References 20 publications

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“…Two wall decompressions via other approaches and one, three, and four wall decompressions have been advocated as well 2-58 12 13 15 16 The most striking complication of transantral two wall decompression is the increased incidence of postoperative imbalance of the extraocular muscles, ranging from 25 to 64% 79 14 16 17 …”

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confidence: 99%

Coronal approach for rehabilitative orbital decompression in Graves' ophthalmopathy

Kalmann

Mourits

Pol

et al. 1997

British Journal of Ophthalmology

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Aims-To determine the eVectiveness and safety of three wall orbital decompression by the coronal approach in Graves' ophthalmopathy. Methods-The records of 125 patients with Graves' ophthalmopathy, who had undergone three wall orbital decompression by coronal approach between April 1984 and October 1993, were studied retrospectively. Special attention was paid to proptosis reduction, changes in ocular motility, and complications. Results-The preoperative Hertel values ranged from 15 to 30 mm (mean 22.43 mm). The mean proptosis reduction was 4.34 mm (range 0-10 mm). Proptosis reduction in patients with preoperative Hertel values higher than 27 mm was significantly more than in patients with preoperative values between 25 and 27 mm (p < 0.05). This last group showed significantly more proptosis reduction than patients with preoperative Hertel values of 23 and 24 mm (p < 0.01). Postoperatively, 3.2% of the patients showed new diplopia in primary and/or reading position. In 4% of the patients with normal ocular motility preoperatively, diplopia in the extreme directions of gaze developed. In 4% of the patients, preoperative motility disturbances decreased or disappeared postoperatively. Conclusion-Three wall orbital decompression by coronal approach is a safe and eVective technique, to achieve proptosis reduction in patients with Graves' ophthalmopathy, with fewer complications than other techniques thus far described. (Br J Ophthalmol 1997;81:41-45)

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confidence: 99%

Coronal approach for rehabilitative orbital decompression in Graves' ophthalmopathy

Kalmann

Mourits

Pol

et al. 1997

British Journal of Ophthalmology

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“…In our study, we have given antithyroid drugs (T. NeoMercazole 5 mg thrice daily), systemic steroids and immunosuppressants. 23,24,27,29,30 In only one case, radioactive iodine was tried because the patient developed agranulocytosis on treatment with NeoMercazole. Systemic steroids are given in 34% cases, majority of which include patients with ocular muscle involvement and optic nerve involvement.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, T1 weighted (orbital fat is bright) MRI produces better anatomic detail without radiation exposure. 25,26,27,28 In this study, 50 consecutive patients were evaluated with ocular signs of hyperthyroidism at the Regional Institute of Ophthalmology, Government Ophthalmic Hospital, Trivandrum. Patients were evaluated clinically with the use of Hertel's exophthalmometer and special investigations serum T3 T4 and TSH levels were done.…”

Section: Euthyroid Graves Ophthalmopathymentioning

confidence: 99%

Ocular Aspects of Hyperthyroidism With Special Reference to Ocular Myopathy

O.U¹,

Job²

2017

jebmh

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BACKGROUND Hyperthyroidism can result in ocular manifestations even before systemic signs and symptoms develop. It is seen more in females and severe forms are more common in males. Early detection of ocular involvement can prevent vision threatening complications and troublesome discomforts affecting quality of vision. This clinical study highlights the importance of detailed ocular examination in hyperthyroidism. MATERIALS AND METHODS Fifty consecutive patients with ocular signs of hyperthyroidism were evaluated and followed up for an average period of 1 year. Detailed ocular examination included exophthalmometric measurements, ocular movements and Worth four-dot test. T3, T4, TSH, CT scan and antimicrosomal antibodies and antithyroglobulin antibodies were done along with routine investigations. Study Design-Prospective cohort study. RESULTS Statistical analysis did not reveal any correlation between the level of serum T3 and severity of ocular findings. Majority of the cases were euthyroid with moderate ocular myopathy having multiple muscle involvement. Inferior rectus was affected most. CONCLUSION The ocular signs of hyperthyroidism in the present study seem to be mild. The severe eye changes like corneal involvement and optic nerve changes were less common.

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“…Management of the lateral orbital rim has cosmetic and functional considerations arguing for and against removal or manipulation. Advantages to removal include more extensive decompression, with some advocating for sole removal or displacement of the lateral orbital rim without further posterior bone removal to achieve decompression [23,24]. Improved visualization in ab-interno approaches by removal of the rim might in turn allow more extensive decompression of the deep lateral orbital wall and subsequent proptosis reduction.…”

Section: Management the Lateral Orbital Rimmentioning

confidence: 99%

Surgical management of the orbit in thyroid eye disease: lateral orbital decompression

Williams

Sahu

2021

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review Lateral orbital wall decompression is one of many well established techniques available to surgeons in management of patients with clinically significant thyroid eye disease (TED). Several different surgical approaches have been described in the literature and are reviewed herein. Recent findings Lateral orbital wall decompression remains a popular technique for surgical management of TED, with a recent American Society of Ophthalmic Plastic and Reconstructive Surgery survey showing that 22.6% of respondents preferred a single-wall procedure, with 36.8% of that subset preferring lateral wall decompression alone. Surgical techniques for lateral orbital wall decompression differ based on several steps, such as the incisional approach, whether to take an ab-interno versus ab-externo approach, and whether to remove orbital fat to achieve further decompression. In addition, technological advances have produced an array of tools available to the orbital surgeon to achieve efficient and accurate bone removal. Summary Lateral orbital wall decompression for TED, despite being an older technique, remains a popular and well established procedure for orbital decompression. Though no randomized controlled clinical trial supports one decompression technique over another for TED, lateral orbital wall decompression offers many benefits such as its ease of access and visualization of the orbital space.

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Decompression for dysthyroid ophthalmopathy via the orbital rim approach

Cited by 10 publications

References 20 publications

Coronal approach for rehabilitative orbital decompression in Graves' ophthalmopathy

Coronal approach for rehabilitative orbital decompression in Graves' ophthalmopathy

Ocular Aspects of Hyperthyroidism With Special Reference to Ocular Myopathy

Surgical management of the orbit in thyroid eye disease: lateral orbital decompression

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