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The incidence of diplopia following coronal and translid orbital decompression in Graves' orbitopathy.
Eye (Lond) 1998; 12 (Pt 5):800-5E

Abstract

PURPOSE

Firstly, to assess the incidence of induced diplopia following orbital decompression in patients with Graves' orbitopathy. Secondly, to assess patient satisfaction after orbital decompression. Thirdly, to determine the factors that contribute to the variable reported incidence of diplopia complicating decompression surgery.

METHODS

We present a retrospective analysis of the alterations of ocular motility in a consecutive series of 81 patients with Graves' orbitopathy who underwent orbital decompression by either a coronal or a translid approach. We assessed patient satisfaction by a telephone survey, and we reviewed the literature.

RESULTS

Eleven patients underwent decompressive surgery for dysthyroid optic neuropathy (DON); 5 of them had a three-wall coronal decompression, the other 6 had a two-wall translid decompression. One of the 5 (20%) coronal versus 2 of the 6 (33%) traslid patients experienced worsening of their existing diplopia. Seventy patients underwent surgery for disfiguring proptosis; 41 of them had a coronal decompression and 29 had a translid decompression. Eight of the 41 coronal patients (20%) and 4 of the 29 translid patients (14%) experienced aggravation of their motility impairment. There was no statistically significant difference between these percentages (chi-squared, p > 0.05). Three of 26 coronal patients (12%) without pre-operative motility impairment developed diplopia in all directions. Twenty-five per cent needed strabismus surgery (9% multiple times). High satisfaction scores were noted after both types of orbital decompression. Through a review of the literature, several factors that may add to heterogeneous results were identified, including definition of diplopia, inclusion criteria and type of surgery.

CONCLUSIONS

Induced diplopia is seen after any type of orbital decompression (19% overall), and its incidence is determined by various factors. To facilitate comparative studies between decompression techniques, a standardised protocol for orthoptic evaluation should be developed.

Authors+Show Affiliations

Donders Institute of Ophthalmology, Department of Orbital Surgery, Academic Hospital Utrecht, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10070513

Citation

Paridaens, D, et al. "The Incidence of Diplopia Following Coronal and Translid Orbital Decompression in Graves' Orbitopathy." Eye (London, England), vol. 12 (Pt 5), 1998, pp. 800-5.
Paridaens D, Hans K, van Buitenen S, et al. The incidence of diplopia following coronal and translid orbital decompression in Graves' orbitopathy. Eye (Lond). 1998;12 (Pt 5):800-5.
Paridaens, D., Hans, K., van Buitenen, S., & Mourits, M. P. (1998). The incidence of diplopia following coronal and translid orbital decompression in Graves' orbitopathy. Eye (London, England), 12 (Pt 5), pp. 800-5.
Paridaens D, et al. The Incidence of Diplopia Following Coronal and Translid Orbital Decompression in Graves' Orbitopathy. Eye (Lond). 1998;12 (Pt 5):800-5. PubMed PMID: 10070513.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The incidence of diplopia following coronal and translid orbital decompression in Graves' orbitopathy. AU - Paridaens,D, AU - Hans,K, AU - van Buitenen,S, AU - Mourits,M P, PY - 1999/3/10/pubmed PY - 1999/3/10/medline PY - 1999/3/10/entrez SP - 800 EP - 5 JF - Eye (London, England) JO - Eye (Lond) VL - 12 (Pt 5) N2 - PURPOSE: Firstly, to assess the incidence of induced diplopia following orbital decompression in patients with Graves' orbitopathy. Secondly, to assess patient satisfaction after orbital decompression. Thirdly, to determine the factors that contribute to the variable reported incidence of diplopia complicating decompression surgery. METHODS: We present a retrospective analysis of the alterations of ocular motility in a consecutive series of 81 patients with Graves' orbitopathy who underwent orbital decompression by either a coronal or a translid approach. We assessed patient satisfaction by a telephone survey, and we reviewed the literature. RESULTS: Eleven patients underwent decompressive surgery for dysthyroid optic neuropathy (DON); 5 of them had a three-wall coronal decompression, the other 6 had a two-wall translid decompression. One of the 5 (20%) coronal versus 2 of the 6 (33%) traslid patients experienced worsening of their existing diplopia. Seventy patients underwent surgery for disfiguring proptosis; 41 of them had a coronal decompression and 29 had a translid decompression. Eight of the 41 coronal patients (20%) and 4 of the 29 translid patients (14%) experienced aggravation of their motility impairment. There was no statistically significant difference between these percentages (chi-squared, p > 0.05). Three of 26 coronal patients (12%) without pre-operative motility impairment developed diplopia in all directions. Twenty-five per cent needed strabismus surgery (9% multiple times). High satisfaction scores were noted after both types of orbital decompression. Through a review of the literature, several factors that may add to heterogeneous results were identified, including definition of diplopia, inclusion criteria and type of surgery. CONCLUSIONS: Induced diplopia is seen after any type of orbital decompression (19% overall), and its incidence is determined by various factors. To facilitate comparative studies between decompression techniques, a standardised protocol for orthoptic evaluation should be developed. SN - 0950-222X UR - https://www.unboundmedicine.com/medline/citation/10070513/The_incidence_of_diplopia_following_coronal_and_translid_orbital_decompression_in_Graves'_orbitopathy_ DB - PRIME DP - Unbound Medicine ER -