Abstract
Endocrine orbitopathy (EO) can have important consequences, such as exophthalmos and
restrictive strabismus. A retrospective study was performed of 35 patients with EO
who underwent orbital decompression surgery and restrictive strabismus correction.
Two surgical techniques for orbital decompression were analyzed: fat decompression
by Olivari technique and three-wall bony expansion with fat decompression. Strabismus
surgery was performed using adjustable or non-adjustable sutures under topical anaesthesia.
Patients were divided into two groups according to the type of intra-orbital decompression
performed, and the postoperative values resulting from the different fat decompression
techniques were recorded. The preoperative and postoperative mean degrees of exophthalmos
were 22.3 and 19.9 mm, respectively, for the fat decompression group, and 24.3 and 19.8 mm, respectively, for the bony expansion with transpalpebral fat decompression (combined
form) group. The difference in residual prism dioptres between adjustable and non-adjustable
suture techniques in patients who had previously undergone combined decompression
was statistically significant. The management of patients with EO requires a multidisciplinary
approach based on the collaboration of maxillofacial surgeons, ophthalmologists, and
orthoptists. These results will allow the development of a more adequate strategy
for the surgical treatment of restrictive strabismus in EO patients.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to International Journal of Oral and Maxillofacial SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Thyroid-associated ophthalmopathy.in: Kanski J.J. Clinical ophthalmology: a systematic approach. 6th ed. Elsevier Masson, 2007: 170-175
- Treatment of thyroid ocular myopathy with adjustable and nonadjustable suture strabismus surgery.Trans Am Ophthalmol Soc. 1993; 91: 67-84
- Extraocular muscle problems in thyroid eye disease.Eye (Lond). 1994; 8: 497-505
- Surgical management of vertical ocular misalignment in thyroid eye disease using an adjustable suture technique.J AAPOS. 2012; 16: 518-522
- Intraoperative adjustable strabismus surgery under drop anesthesia in patients with Graves’ orbitopathy.Arq Bras Oftalmol. 2008; 71: 370-374
- Strabismus surgery for thyroid associated orbitopathy.in: Proceedings of the 19th Congress of the European Association for Cranio-Maxillo-Facial Surgery, September 9–12, Bologna, Italy2008
- Adjustable suture strabismus surgery.Eye (Lond). 2011; 25: 1262-1270
- Adjustable versus non-adjustable sutures in strabismus surgery in patients with thyroid ophthalmopathy.Cesk Slov Oftalmol. 2012; 68: 207-213
- Transpalpebral decompression of endocrine ophthalmopathy (Graves’ disease) by removal of intraorbital fat: experience with 147 operations over 5 years.Plast Reconstr Surg. 1991; 87: 627-641
- Endocrine orbitopathy: 11 years retrospective study and review of 102 patients and 196 orbits.J Craniofac Surg. 2012; 40: 134-141
- Transantral orbital decompression for malignant exophthalmos.Laryngoscope. 1957; 67: 544-568
- Orbital decompression for dysthyroid orbitopathy: a review of techniques and indications.J Fr Ophtalmol. 2004; 27: 828-844
- Rationale of treatment in Graves ophthalmopathy.Plast Reconstr Surg. 2001; 108: 1880-1890
- New mini-osteotomy of the infraorbital nerve in bony decompression for endocrine orbitopathy.J Craniofac Surg. 2010; 21: 222-224
- Surgical strategy in the treatment of globe protrusion depending on its mechanism (Graves’ disease, nonsyndromic exorbitism, or high myopia).Plast Reconstr Surg. 2006; 117: 553-564
Article info
Publication history
Published online: January 06, 2016
Accepted:
December 1,
2015
Identification
Copyright
© 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
