J Korean Ophthalmol Soc > Volume 60(11); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(11):1015-1020.
DOI: https://doi.org/10.3341/jkos.2019.60.11.1015    Published online November 15, 2019.
The Clinical Result of Medial Orbital Decompression in Patients with Thyroid-associated Orbitopathy.
Na Ri Park, Jeong Kyu Lee
Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea. lk1246@hanmail.net
갑상샘눈병증환자에서 내벽 안와감압술의 임상효과
박나리 · 이정규
중앙대학교 의과대학 중앙대학교병원 안과학교실
Correspondence:  Jeong Kyu Lee,
Email: lk1246@hanmail.net
Received: 2 May 2019   • Revised: 26 June 2019   • Accepted: 24 October 2019
Abstract
PURPOSE
To evaluate the clinical effects of medial orbital decompression in patients with thyroid orbitopathy. METHODS: Forty-three orbits of 28 patients who underwent medial orbital decompression for cosmetic purposes between January 2014 to January 2017 were retrospectively reviewed. Changes in visual acuity, intraocular pressure, exophthalmos, strabismus, and diplopia were checked before, 3 months, and 1 year after surgery. RESULTS: The average exophthalmos reduction was −2.99 ± 0.96 mm at postoperative 3 months and −3.07 ± 1.24 mm after 1 year (both, p < 0.001). In patients who underwent unilateral orbital decompression, the mean difference in exophthalmometry between the two eyes was significantly reduced from 3.06 ± 0.78 mm to 0.38 ± 0.44 mm after 3 months, and to 0.50 ± 0.46 mm after 1 year (p = 0.011 and p = 0.012, respectively). After surgery, the final postoperative intraocular pressure decreased significantly at postoperative 3 months and 1 year (both, p < 0.001). The mean preoperative horizontal deviation was 0.88 ± 4.85 prism diopters (PD) and 5.50 ± 6.74 PD at postoperative 3 months, which demonstrated significant esodeviation postoperatively (p = 0.007). Three patients had new onset esotropia (8.33%), but no surgical treatment was needed. CONCLUSIONS: Medial orbital decompression is a less invasive and safe surgical procedure for patients with asymmetric or mild thyroid-associated orbitopathy, which can be beneficial for reducing proptosis.
Key Words: Diplopia;Exophthalmos;Orbital decompression;Thyroid-associated orbitopathy


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