Intraocular Pressure and Refractive Changes Following Orbital Decompression with Intraconal Fat Excision

Sagili, Suresh; deSousa, Jean-Louis; Malhotra, Raman

doi:10.2174/1874364100802010073

Cited by 12 publications

(15 citation statements)

References 17 publications

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“…This audit standardises for CCT, which has not been well described previously [5][6][7][8][9]16,28,29 and is known to significantly affect IOP. 30 Goldberg 31 commented that in patients with TO, central corneal thickness is a confounder for accurate tonometry, and that apparent changes in IOP could be simply due to increases in CCT.…”

Section: Discussionmentioning

confidence: 99%

The effect of orbital decompression surgery on refraction and intraocular pressure in patients with thyroid orbitopathy

Norris

Ross

Kazim

et al. 2012

Eye

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Purpose To investigate the effect of orbital decompression surgery in thyroid orbitopathy (TO) on both refractive status and intraocular pressure (IOP). Patients and methods A prospective, multicentre, consecutive audit of patients undergoing thyroid decompression surgery. Indications for surgery included cosmetically unacceptable proptosis or corneal exposure. Exclusion criteria included the following: previous orbital surgery, glaucoma, corneal disease, steroid use in the preceding 12 months, or an acute optic neuropathy. Automated refraction, keratometry, pachymetry, Hertel exophthalmometry, and IOP were recorded at 1 month pre-and 3 months postoperatively. IOP using the Tono-Pen (mean of three readings) was measured in the primary, upgaze, and downgaze positions. Results Data were collected from 52 orbits of 33 patients (East Grinstead, New York, and Adelaide). There was no significant difference between pre-and postoperative data for sphere, cylinder, or central corneal thickness (CCT). The mean spherical equivalent was À0.43±1.49 D pre-operatively and À0.28±1.52 D postoperatively. The steepest meridian of corneal curvature was 93.1 degrees pre-and 94.2 degrees postoperatively, with no significant difference. Mean IOP significantly decreased when measuring by Goldmann applanation tonometry (GAT) (2.28 mm Hg, *P ¼ 0.001) and Tono-Pen (3.06 mm Hg, *P ¼ o0.0001). IOP measured in upgaze was significantly greater than that in the primary position. Regression analysis between change in IOP and either Hertel exophthalmometry or the number of orbital walls decompressed was non-significant (*Student's t-test). Conclusion Patients with TO undergoing orbital decompression had, on average, with-the-rule astigmatism not affected by orbital decompression surgery. IOP was significantly reduced by decompression surgery although no relationship between IOP and the degree of decompression was observed.

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Section: Discussionmentioning

confidence: 99%

The effect of orbital decompression surgery on refraction and intraocular pressure in patients with thyroid orbitopathy

Norris

Ross

Kazim

et al. 2012

Eye

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“…[8][9][10] However, whether or not myopic shift is induced by surgery is uncertain. In our study, the mean spherical refraction was decreased by 0.38 D with the myopic change.…”

Section: Resultsmentioning

confidence: 99%

“…For patients undergoing successful decompression, we can estimate ophthalmic status prior to the start of proptosis. Although there have been studies reporting the effect of orbital decompression on refraction, [8][9][10] whether or not refractive error is induced or not remains uncertain. In this study, we assessed the biometrics of the eyeball, including axial length (AL), anterior chamber depth (ACD), lens thickness (LT), refraction, keratometry, and aberration, before and after orbital decompression in order to estimate the correlation between proptosis progression and biometric changes.…”

Section: Introductionmentioning

confidence: 99%

Biometric and refractive changes after orbital decompression in Korean patients with thyroid-associated orbitopathy

Kim

Chun

Cho

et al. 2015

Eye

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Purpose To determine the biometric and refractive changes after orbital decompression in Korean patients with thyroid-associated orbitopathy (TAO). Methods Retrospective, observational study (between October 2012 and September 2014) was performed. Patients with TAO undergoing orbital decompression for stable proptosis received ophthalmic examinations, including Hertel exophthalmometry, A-scan biometry, autorefraction measures, corneal topography, and wavefront aberration measures, before orbital decompression and again 2 months after surgery. Results Included in the study were 43 eyes from 23 patients. The mean exophthalmometric value decreased by 4.1 mm 2 months after orbital decompression (Po0.001). On average, axial length (AL) increased significantly by 0.08 mm (Po0.001); specifically, 37 (86%) of the 43 eyes had increased AL. Whereas anterior chamber depth and lens thickness showed no significant changes (P = 0.086 and P = 0.905, respectively), the mean spherical refraction and spherical equivalent (SE) decreased by 0.35 and 0.48 D, respectively (P = 0.008 and Po0.001, respectively). However, cylindrical refraction and axis showed no significant changes (P = 0.057 and P = 0.218, respectively). The changes in AL and SE were significantly correlated (R = − 0.411, P = 0.009). Notably, there were no changes in corneal topography or wavefront aberration after orbital decompression. Conclusions TAO patients who underwent orbital decompression showed myopic refractive change via increase in AL. Possible refractive changes should be considered in cases of TAO complaining of decreased visual acuity after orbital decompression.

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“…Also in support are studies that found no difference in the pre-and postoperative keratometry after orbital decompression for thyroid eye disease. 20,21 The amount of astigmatism induced is dependent on the location of the tumor, but not on the amount of proptosis or duration of illness.…”

Section: Discussionmentioning

confidence: 99%

Visual function alterations in orbital tumors and factors predicting visual outcome after surgery

Singh

Pushker

Bajaj

et al. 2011

Eye

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Purpose To study the effect of orbital tumors on visual functions and highlight the factors predictive of visual outcome after surgery. Methods A prospective interventional study compared visual function parameters and fundus changes, before and after surgery, in eyes having well-defined orbital tumors with the normal fellow eye. These included visual acuity (VA), refractive error, keratometry changes, color vision, Goldmann visual field (GVF), and visual evoked response (VER). Results In total 28 cases (age range 7-56 years), of which the majority of tumors were vascular (46%) and lacrimal (18%) in origin, had a mean VA of 0.54±0.33 in the affected eye, which improved postoperatively to 0.66 ± 0.31 (P ¼ 0.002). The affected eye had a median refractive error of þ 0.00 DS (À2.00 to 5.13), which was significantly more hyperopic than the normal eye (median þ 0.00 DS; range À1.25 to þ 1.63 DS) and normalized postoperatively. Keratometry showed higher astigmatism in the involved eye (P ¼ 0.004). The fundus showed disc pallor, edema, and/or choroidal folds, of which disc edema resolved in all cases after surgery. In all, 40% of the affected eyes had a deficient color vision and this partially improved postoperatively (P ¼ 0.25). GVF had abnormalities in 10 cases, half of which normalized postoperatively (P ¼ 0.04). The VER of affected eyes had a mean amplitude of 8.91 ± 4.59 lv and latency of 116.3 ± 14.7 ms, with improvement after surgery (P ¼ 0.005 and 0.001, respectively). Conclusion Orbital tumors adversely affected visual functions. The presenting acuity depended on disc changes, color vision abnormalities, and prolonged VER latency. The postoperative VA depended on VA at presentation, amount of proptosis, degree of hyperopia, and clinically significant VER abnormalities.

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Intraocular Pressure and Refractive Changes Following Orbital Decompression with Intraconal Fat Excision

Cited by 12 publications

References 17 publications

The effect of orbital decompression surgery on refraction and intraocular pressure in patients with thyroid orbitopathy

The effect of orbital decompression surgery on refraction and intraocular pressure in patients with thyroid orbitopathy

Biometric and refractive changes after orbital decompression in Korean patients with thyroid-associated orbitopathy

Visual function alterations in orbital tumors and factors predicting visual outcome after surgery

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