J Korean Ophthalmol Soc.  2010 Apr;51(4):473-478. 10.3341/jkos.2010.51.4.473.

Long-term Result of Fat Orbital Decompression

• Park JH
• Lee TS
• Kay KM

• KMID: 2213375
• DOI: http://doi.org/10.3341/jkos.2010.51.4.473

Abstract

PURPOSE
To evaluate the long-term results of orbital fat decompression with or without lateral wall decompression in Grave's ophthalmopathy.
METHODS
The authors studied retrospectively the 24 thyroid-related orbitopathy patients (32 eyes) who had undergone fat removal decompression or combined orbital decompression (lateral wall decompression with fat removal) based on average exophthalmometric values for Koreans. The patients were followed for over six months postoperatively, from December 2000 to December 2008.
RESULTS
The average amount of exophthalmos reduction was 4.13+/-2.60 mm in the fat removal decompression group and 5.79+/-2.02 mm in the combined orbital decompression group, respectively (p<0.001). The final postoperative BCVA (best corrected visual acuity) in patients with compressive optic neuropathy improved in all cases. Intraocular pressure decreased significantly in all groups after operation (p<0.001). Except for one patient who had newly onset diplopia, which was transient, no patient's diplopia worsened.
CONCLUSIONS
The authors obtained excellent surgical results in the treatment of orbital decompression and cosmesis without complications that can result from fat removal decompression or combined orbital decompression.

Keyword

Exophthalmos; Fat decompression; Orbital decompression; Thyroid-related orbitopathy

MeSH Terms

Decompression
Diplopia
Exophthalmos
Humans
Intraocular Pressure
Optic Nerve Diseases
Orbit
Retrospective Studies

Figure

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  Figure 1. Lateral wall sculpting using a high speed rotating diamond burr.

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  Figure 2. Removed orbital fat.

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  Figure 3. (Left) Exophthalmos of the right eye is noted preoperatively. (Right) Exophthalmos is significantly reduced by lateral wall and fat decompression of the right eye.

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  Figure 4. Pre-(left) and post-operative (right) orbit CT scans show a reduction of exophthalmos of the right orbit.

Reference

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