Tags

Type your tag names separated by a space and hit enter

Endoscopic medial orbital fat decompression for proptosis in type 1 graves orbitopathy.
Am J Ophthalmol 2015; 159(2):277-84AJ

Abstract

PURPOSE

To describe the surgical technique for endoscopic medial orbital fat decompression in type 1 (lipogenic) Graves orbitopathy and report outcomes.

DESIGN

Retrospective interventional case review.

METHODS

We reviewed 108 patients (206 orbits) with inactive, type 1 Graves orbitopathy without diplopia, who underwent endoscopic medial orbital fat decompression solely for proptosis reduction. Following endoscopic transethmoid medial orbital wall decompression, extraconal and intraconal orbital fat was removed with a low-suction cutting instrument. All patients were followed up for at least 12 months. Surgical time, preoperative and postoperative Hertel exophthalmometry, incidence of postoperative diplopia within 30-degree visual field in the primary gaze, and other complications were analyzed.

RESULTS

The mean surgical time was 97.7 ± 16.7 minutes (67-136 minutes). The mean follow-up was 16.0 ± 4.2 months (12-24 months). Preoperative and postoperative proptosis values at final review were 21.1 ± 2.3 mm (17-26 mm) and 13.0 ± 0.9 mm (12-15 mm), respectively (P < .001). Median reduction in proptosis was 8.0 mm with mean of 8.2 ± 1.8 mm (4-11 mm). Symmetry to within 2 mm was achieved in 106 of 108 patients (98.1%). Twenty-five of 108 patients (23.1%) had diplopia within 30-degree visual field of the gaze, and 23 of these had complete resolution within 3 months, while the remaining 2 patients required squint surgery.

CONCLUSIONS

Endoscopic medial orbital fat decompression may be an effective technique for proptosis in selected patients with type 1 Graves orbitopathy and is associated with a low rate of surgically induced diplopia.

Authors+Show Affiliations

Department of Orbital & Oculoplastic Surgery, The Eye Hospital of Wenzhou Medical University, Wenzhou, China. Electronic address: wuwencan118@163.com.Discipline of Ophthalmology & Visual Sciences, University of Adelaide and South Australian Institute of Ophthalmology, Adelaide, Australia.Department of Orbital & Oculoplastic Surgery, The Eye Hospital of Wenzhou Medical University, Wenzhou, China.Department of Ophthalmology, Jinhua Center Hospital, Jinhua, China.Discipline of Ophthalmology & Visual Sciences, University of Adelaide and South Australian Institute of Ophthalmology, Adelaide, Australia.Department of Ophthalmology, Lihuili Hospital, Ningbo, China.Department of Orbital & Oculoplastic Surgery, The Eye Hospital of Wenzhou Medical University, Wenzhou, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25448997

Citation

Wu, Wencan, et al. "Endoscopic Medial Orbital Fat Decompression for Proptosis in Type 1 Graves Orbitopathy." American Journal of Ophthalmology, vol. 159, no. 2, 2015, pp. 277-84.
Wu W, Selva D, Bian Y, et al. Endoscopic medial orbital fat decompression for proptosis in type 1 graves orbitopathy. Am J Ophthalmol. 2015;159(2):277-84.
Wu, W., Selva, D., Bian, Y., Wang, X., Sun, M. T., Kong, Q., & Yan, W. (2015). Endoscopic medial orbital fat decompression for proptosis in type 1 graves orbitopathy. American Journal of Ophthalmology, 159(2), pp. 277-84. doi:10.1016/j.ajo.2014.10.029.
Wu W, et al. Endoscopic Medial Orbital Fat Decompression for Proptosis in Type 1 Graves Orbitopathy. Am J Ophthalmol. 2015;159(2):277-84. PubMed PMID: 25448997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic medial orbital fat decompression for proptosis in type 1 graves orbitopathy. AU - Wu,Wencan, AU - Selva,Dinesh, AU - Bian,Yang, AU - Wang,Xiaopeng, AU - Sun,Michelle T, AU - Kong,Qiao, AU - Yan,Wentao, Y1 - 2014/11/01/ PY - 2014/04/16/received PY - 2014/10/26/revised PY - 2014/10/27/accepted PY - 2014/12/3/entrez PY - 2014/12/3/pubmed PY - 2015/2/28/medline SP - 277 EP - 84 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 159 IS - 2 N2 - PURPOSE: To describe the surgical technique for endoscopic medial orbital fat decompression in type 1 (lipogenic) Graves orbitopathy and report outcomes. DESIGN: Retrospective interventional case review. METHODS: We reviewed 108 patients (206 orbits) with inactive, type 1 Graves orbitopathy without diplopia, who underwent endoscopic medial orbital fat decompression solely for proptosis reduction. Following endoscopic transethmoid medial orbital wall decompression, extraconal and intraconal orbital fat was removed with a low-suction cutting instrument. All patients were followed up for at least 12 months. Surgical time, preoperative and postoperative Hertel exophthalmometry, incidence of postoperative diplopia within 30-degree visual field in the primary gaze, and other complications were analyzed. RESULTS: The mean surgical time was 97.7 ± 16.7 minutes (67-136 minutes). The mean follow-up was 16.0 ± 4.2 months (12-24 months). Preoperative and postoperative proptosis values at final review were 21.1 ± 2.3 mm (17-26 mm) and 13.0 ± 0.9 mm (12-15 mm), respectively (P < .001). Median reduction in proptosis was 8.0 mm with mean of 8.2 ± 1.8 mm (4-11 mm). Symmetry to within 2 mm was achieved in 106 of 108 patients (98.1%). Twenty-five of 108 patients (23.1%) had diplopia within 30-degree visual field of the gaze, and 23 of these had complete resolution within 3 months, while the remaining 2 patients required squint surgery. CONCLUSIONS: Endoscopic medial orbital fat decompression may be an effective technique for proptosis in selected patients with type 1 Graves orbitopathy and is associated with a low rate of surgically induced diplopia. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/25448997/Endoscopic_medial_orbital_fat_decompression_for_proptosis_in_type_1_graves_orbitopathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(14)00694-1 DB - PRIME DP - Unbound Medicine ER -