Ultrasonic Bone Removal Versus High-Speed Burring for Lateral Orbital Decompression: Comparison of Surgical Outcomes for the Treatment of Thyroid Eye Disease

Abstract Background Postoperative ocular imbalance is an important problem for orbital decompression surgery in thyroid eye disease (TED). The aim of this study was to evaluate the changes in unilateral ocular deviation and duction following orbital decompression and discuss the biomechanics of ocular imbalance. Methods Fifty-four TED patients who underwent unilateral orbital decompression were included. Fifteen patients underwent 1-wall (deep lateral wall) decompression, 18 patients underwent 2-wall (deep lateral and medial wall) decompression and 21 patients underwent 3-wall (deep lateral, medial and inferior wall) decompression. Objective and subjective deviation of the operated eyes were evaluated using the prism test and synoptophore, respectively. Ocular ductions were measured using Hirschberg’s method. The diameters of the extraocular rectus were measured by computed tomography. Results Ocular deviation and duction showed no significant difference after 1-wall decompression (p = 0.25–0.89). Esotropia increased after 2-wall decompression (p = 0.001–0.02), and hypotropia increased after 3-wall decompression (p = 0.02). Adduction increased but abduction decreased following 2-wall and 3-wall decompression (p < 0.05). Infraduction increased following 3-wall decompression (p < 0.001). Additionally, the increase in esotropia was significantly correlated with the increase in adduction and with the decrease in abduction (r = 0.37–0.63, p < 0.05). There were significant correlations between the diameter of the medial rectus and the increase in esotropia, the increase in adduction and the decrease in abduction postoperatively (r = 0.35–0.48, p < 0.05). Conclusions The changes in ocular deviation and duction were different after 1-wall, 2-wall and 3-wall orbital decompression. The increased contractile force of the rectus may be an important reason for strabismus changes after orbital decompression surgery.

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Patients’ expectations for the functional and psychosocial outcomes of orbital decompression surgery for thyroid eye disease: a qualitative study

Psychology Health & Medicine ◽

10.1080/13548506.2017.1356930 ◽

2017 ◽

Vol 23 (4) ◽

pp. 475-484

Author(s):

Sadie Wickwar ◽

Hayley McBain ◽

Matthew R. Edmunds ◽

Daniel G. Ezra ◽

Geoffrey E. Rose ◽

...

Keyword(s):

Qualitative Study ◽

Psychosocial Outcomes ◽

Thyroid Eye Disease ◽

Eye Disease ◽

Decompression Surgery ◽

Orbital Decompression

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Central Retinal Vein Occlusion Resolving After Orbital Decompression in Thyroid Eye Disease

Ophthalmic Plastic and Reconstructive Surgery ◽

10.1097/iop.0000000000000635 ◽

2017 ◽

Vol 33 ◽

pp. S188-S190

Author(s):

Seanna R. Grob ◽

Michael K. Yoon

Keyword(s):

Retinal Vein Occlusion ◽

Central Retinal Vein Occlusion ◽

Thyroid Eye Disease ◽

Eye Disease ◽

Orbital Decompression ◽

Vein Occlusion ◽

Central Retinal Vein

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Correlation Between Uniocular Deviation and Duction Changes Following Different Decompression Surgeries in Thyroid Eye Disease

10.21203/rs.3.rs-121874/v1 ◽

2020 ◽

Author(s):

Jie Guo ◽

Xiaofeng Li ◽

Ruiqi Ma ◽

Jiang Qian

Keyword(s):

Lateral Wall ◽

Thyroid Eye Disease ◽

Eye Disease ◽

Decompression Surgery ◽

Inferior Wall ◽

Orbital Decompression ◽

Orbital Cavity ◽

Significant Difference ◽

Ocular Deviation ◽

Fellow Eyes

Abstract Background: Postoperative ocular imbalance is an important problem for orbital decompression surgery in thyroid eye disease (TED). To evaluate the changes of unilateral ocular deviation and duction following orbital decompression and discuss the possible biomechanics of ocular imbalance.Methods: Fifty-four TED patients who underwent unilateral orbital decompression were included. 15 patients underwent 1-wall (deep lateral wall) decompression, 18 patients underwent 2-wall (deep lateral and medial wall) decompression and 21 patients underwent 3-wall (deep lateral, medial and inferior wall) decompression. Objective and subjective deviation of the operated eyes compared with the fellow eyes were evaluated using prism test and synoptophore, respectively. Ocular ductions were measured using Hirschberg’s method. The diameters of extraocular rectus were measured by computed tomography.Results: Ocular deviation and duction showed no significant difference after 1-wall decompression (p=0.25~0.89). Esotropia increased after 2-wall decompression (p=0.001~0.02). Hypotropia increased after 3-wall decompression (p=0.02). Adduction increased but abduction decreased following 2-wall and 3-wall decompression (p<0.05). Infraduction increased following 3-wall decompression (p<0.001). Additionally, the increase of esotropia had significant correlations with the increase of adduction and with the decrease of abduction (r=0.37~0.63, p<0.05). There were significant correlations between the diameter of medial rectus and the increase of esotropia, the increase of adduction and the decrease of abduction postoperatively (r=0.35~0.48, p<0.05).Conclusions: The changes in ocular deviation and duction were different after 1-wall, 2-wall and 3-wall orbital decompression. The expansion of orbital cavity and the increased contractile force of rectus might be important reasons for strabismus changes following decompression surgery.

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Spontaneous orbital decompression in thyroid eye disease: new measurement methods and its influential factors

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-020-04762-0 ◽

2020 ◽

Vol 258 (10) ◽

pp. 2321-2329

Author(s):

Aric Vaidya ◽

Patricia Ann L. Lee ◽

Yoshiyuki Kitaguchi ◽

Hirohiko Kakizaki ◽

Yasuhiro Takahashi

Keyword(s):

Measurement Methods ◽

Influential Factors ◽

Thyroid Eye Disease ◽

Eye Disease ◽

Orbital Decompression

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ORBITAL DECOMPRESSION FOR OPTIC NEUROPATHY SECONDARY TO THYROID EYE DISEASE

The Laryngoscope ◽

10.1288/00005537-198807000-00004 ◽

1988 ◽

Vol 98 (7) ◽

pp. 712???716 ◽

Cited By ~ 6

Author(s):

STEVEN D. SCHAEFER ◽

JAMES H. MERRITT ◽

LANNY G. CLOSE

Keyword(s):

Optic Neuropathy ◽

Thyroid Eye Disease ◽

Eye Disease ◽

Orbital Decompression

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Surgical orbital decompression for thyroid eye disease

10.1002/14651858.cd007630 ◽

2009 ◽

Cited By ~ 3

Author(s):

Kostas G Boboridis ◽

Catey Bunce

Keyword(s):

Thyroid Eye Disease ◽

Eye Disease ◽

Orbital Decompression

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Orbital decompression for thyroid eye disease: a comparison of external and endoscopic techniques

The Journal of Laryngology & Otology ◽

10.1017/s0022215100139313 ◽

1997 ◽

Vol 111 (11) ◽

pp. 1051-1055 ◽

Cited By ~ 50

Author(s):

Valerie J. Lund ◽

Genevieve Larkin ◽

Peter Fells ◽

Gillian Adams

Keyword(s):

Visual Acuity ◽

Endoscopic Approach ◽

Thyroid Eye Disease ◽

Eye Disease ◽

Orbital Decompression ◽

External Approach ◽

Endoscopic Techniques

AbstractThe results of orbital decompression for thyroid eye disease are presented in a cohort of 33 patients. It was performed by an external Patterson approach in 21 individuals and in 13 by an endonasal endoscopic approach. The endoscopic approach was entirely comparable in respect of improvement in axial proptosis, giving a mean improvement of 4.4 mm as compared with a mean of 3.8 mm for the external approach, and produced a demonstrable improvement in visual acuity and perception of colour in three individuals, where this was compromised, and was associated with fewer complications.

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