Surgical Management of Ocular Complications of Graves' Disease

Schimek, Robert A.

doi:10.1001/archopht.1972.01000020657009

Cited by 38 publications

(5 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In fibrosis, the lower eyelid retractor is intrinsically connected in the capsulopalpebral fascia with the inferior rectus muscle, which is commonly affected in TED. Changes in the inferior rectus muscle dimensions or fibrosis of the capsulopalpebral fascia can cause lower eyelid retraction [22][23][24][27][28][29][30][31][32]. Hence, orbital decompression alone cannot completely correct eyelid retraction.…”

Section: Discussionmentioning

confidence: 99%

Changes in Eyelid Parameters after Orbital Decompression according to the Surgical Approach in Thyroid Eye Disease

Kim

Kang

2021

Korean J Ophthalmol

View full text Add to dashboard Cite

To evaluate the changes in eyelid parameters after the endonasal approach compared with transcaruncular medial wall decompression combined with the transconjunctival inferior wall decompression approach with inferomedial strut preservation.Methods: In total, 71 patients with thyroid eye disease who underwent orbital decompression were retrospectively evaluated. The data collected included Hertel exophthalmometry, marginal reflex distance 1, marginal reflex distance 2, interpalpebral fissure, levator function test measures, and complications related to surgery.Results: Proptosis reduction produced a statistically significant improvement across all decompression groups. Lower eyelid retraction produced a statistically significant improvement in the two-wall decompression groups but not in the one-wall decompression groups. No statistical difference was observed in the upper eyelid retraction and levator function after surgery across all decompression groups. In the post-hoc analysis, statistical improvement was not observed in the lower eyelid retraction between the endonasal and transcaruncular approach in the one-wall and twowall decompression groups, although statistically significant exophthalmos reduction and improvement in the lower eyelid retraction was noted in the two-wall decompression subgroups compared with one-wall decompression subgroups. Conclusions:Our study showed no differences in eyelid parameters between the endonasal and transcaruncular decompression approaches in one-wall and two-wall decompression. In the two-wall decompression group, proptosis reduction was greater with the endonasal approach than with the transcaruncular approach when the strut was preserved; however, it does not lead to a significant difference in the improvement of lower eyelid retraction.

show abstract

Section: Discussionmentioning

confidence: 99%

Changes in Eyelid Parameters after Orbital Decompression according to the Surgical Approach in Thyroid Eye Disease

Kim

Kang

2021

Korean J Ophthalmol

View full text Add to dashboard Cite

show abstract

“…Good results may be considered as attaining of a useful field of SBV, comprising both primary position and downgaze [5]. It is important to obtain an area of single binocular vision immediately after surgery.…”

Section: What Can You Realistically Expect From Surgery?mentioning

confidence: 99%

Eye Muscle Surgery

Nardi¹

2010

Graves' Orbitopathy

View full text Add to dashboard Cite

“…Examining versions these patients show an apparent hypertropia of the adducted eye simulating IOM hyperfunction, common in concomitant strabismus. The hypertropia of the adducted eye in GO is usually due to a restriction of the contralateral IRM: in this case IRM has to be weakened ( Figure 2) and surgery on IOM will result in a disaster (Shimek, 1972). Pseudoparalysis of superior oblique muscle b.…”

Section: Diagnosis Of the Affected Musclesmentioning

confidence: 99%

Squint Surgery in TED - Hints and Fints, or Why Graves' Patients Are Difficult Patients

Nardi¹

2009

NORB

View full text Add to dashboard Cite

Endocrine ophthalmopathy is the most common cause of acute onset diplopia in middle aged or older individuals. Ocular muscle involvement is characterized by myositis followed by fibrosis: this causes a stiffness and a shortening of the muscles involved with restriction of ocular movements: so the impairment of rotation is due to a mechanical obstacle and not to a paresis. Prisms are rarely useful in relieving diplopia and the majority of symptomatic patients need squint surgery. Timing of surgery is very important and two considerations are to be kept in mind: first, the systemic disease must be in remission and the ocular deviation must be stable for at least six months; second, if more than one surgical procedure is needed for the ophthalmopathy, muscle surgery has its right place after orbital surgery and before lid surgery. Obviously dealing with restrictive disorders, surgery is based on weakening procedures of the affected muscles: identifying the affected muscles is of crucial importance and may be sometime difficult for the presence of misleading signs; great advances have been made in surgical technique with the development of adjustable sutures and of topical anesthesia. Prognosis is usually good with more than 80% of patients recovering a useful field of binocular single vision with one procedure and more than 90% with two or more procedures.

show abstract

Surgical Management of Ocular Complications of Graves' Disease

Cited by 38 publications

References 5 publications

Changes in Eyelid Parameters after Orbital Decompression according to the Surgical Approach in Thyroid Eye Disease

Changes in Eyelid Parameters after Orbital Decompression according to the Surgical Approach in Thyroid Eye Disease

Eye Muscle Surgery

Squint Surgery in TED - Hints and Fints, or Why Graves' Patients Are Difficult Patients

Contact Info

Product

Resources

About