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Endoscopical Orbital Fat Decompression with Medial Orbital Wall Decompression for Dysthyroid Optic Neuropathy.
Curr Eye Res. 2016; 41(2):150-8.CE

Abstract

OBJECTIVE

To describe a novel approach to orbital decompression for dysthyroid optic neuropathy (DON).

METHODS

An augmented endoscopic transethmoid medial orbital wall decompression (ETMOWD) was performed on 43 consecutive patients (72 eyes) with DON in order to access the orbital apex adequately. Concurrently, endoscopic transethmoid fat decompression (ETFD) using a novel aspiration/cutting instrument to remove orbital fat was performed for further reduction of proptosis. All patients were followed up periodically for at least 6 months. Outcomes such as improvement of visual acuity (VA), color vision, degree of proptosis reduction as well as the incidence of surgical induced diplopia were analyzed at the final review.

RESULTS

Sixty-nine out of 72 eyes (95.8%) had a statistically significant improvement in VA from -0.65 ± 0.30 to -0.25 ± 0.22 postoperatively, with a mean improvement of 0.55 ± 0.17 (p < 0.001). Thirty-four out of 45 eyes had an improvement in color vision (p < 0.001). The range of proptosis reduction was 4 to 9 mm (mean 6.2 ± 1.2 mm). Postoperative symmetry was achieved to within 2 mm using an exophthalmometer in 39 of 43 patients (90.7%). Five patients developed diplopia in the postoperative phase, but had complete resolution within 3 months. Two patients had further deterioration in their diplopia following surgery.

CONCLUSION

Our technique of a combined ETFD with ETMOWD appears to be effective in managing patients with DON, with minimal morbidities and a low incidence of postoperative diplopia.

Authors+Show Affiliations

a Department of Ophthalmology , Jinhua Center Hospital , Jinhua , Zhejiang , P.R. China .b Discipline of Ophthalmology & Visual Sciences, University of Adelaide and South Australian Institute of Ophthalmology , Adelaide , Australia .c Department of Orbital & Oculoplastic Surgery , Eye Hospital of Wenzhou Medical University , Wenzhou , Zhejiang , P.R. China and.d Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami , FL , USA.c Department of Orbital & Oculoplastic Surgery , Eye Hospital of Wenzhou Medical University , Wenzhou , Zhejiang , P.R. China and.c Department of Orbital & Oculoplastic Surgery , Eye Hospital of Wenzhou Medical University , Wenzhou , Zhejiang , P.R. China and.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25835075

Citation

Lv, Zhigang, et al. "Endoscopical Orbital Fat Decompression With Medial Orbital Wall Decompression for Dysthyroid Optic Neuropathy." Current Eye Research, vol. 41, no. 2, 2016, pp. 150-8.
Lv Z, Selva D, Yan W, et al. Endoscopical Orbital Fat Decompression with Medial Orbital Wall Decompression for Dysthyroid Optic Neuropathy. Curr Eye Res. 2016;41(2):150-8.
Lv, Z., Selva, D., Yan, W., Daniel, P., Tu, Y., & Wu, W. (2016). Endoscopical Orbital Fat Decompression with Medial Orbital Wall Decompression for Dysthyroid Optic Neuropathy. Current Eye Research, 41(2), 150-8. https://doi.org/10.3109/02713683.2015.1008640
Lv Z, et al. Endoscopical Orbital Fat Decompression With Medial Orbital Wall Decompression for Dysthyroid Optic Neuropathy. Curr Eye Res. 2016;41(2):150-8. PubMed PMID: 25835075.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopical Orbital Fat Decompression with Medial Orbital Wall Decompression for Dysthyroid Optic Neuropathy. AU - Lv,Zhigang, AU - Selva,Dinesh, AU - Yan,Wentao, AU - Daniel,Pelaez, AU - Tu,Yunhai, AU - Wu,Wencan, Y1 - 2015/04/02/ PY - 2015/4/4/entrez PY - 2015/4/4/pubmed PY - 2016/10/27/medline KW - Dythyroid optic neuropathy KW - endoscopic transethomoid medial orbital wall decompression KW - endoscopic transethomoid orbital fat decompression KW - proptosis reduction SP - 150 EP - 8 JF - Current eye research JO - Curr. Eye Res. VL - 41 IS - 2 N2 - OBJECTIVE: To describe a novel approach to orbital decompression for dysthyroid optic neuropathy (DON). METHODS: An augmented endoscopic transethmoid medial orbital wall decompression (ETMOWD) was performed on 43 consecutive patients (72 eyes) with DON in order to access the orbital apex adequately. Concurrently, endoscopic transethmoid fat decompression (ETFD) using a novel aspiration/cutting instrument to remove orbital fat was performed for further reduction of proptosis. All patients were followed up periodically for at least 6 months. Outcomes such as improvement of visual acuity (VA), color vision, degree of proptosis reduction as well as the incidence of surgical induced diplopia were analyzed at the final review. RESULTS: Sixty-nine out of 72 eyes (95.8%) had a statistically significant improvement in VA from -0.65 ± 0.30 to -0.25 ± 0.22 postoperatively, with a mean improvement of 0.55 ± 0.17 (p < 0.001). Thirty-four out of 45 eyes had an improvement in color vision (p < 0.001). The range of proptosis reduction was 4 to 9 mm (mean 6.2 ± 1.2 mm). Postoperative symmetry was achieved to within 2 mm using an exophthalmometer in 39 of 43 patients (90.7%). Five patients developed diplopia in the postoperative phase, but had complete resolution within 3 months. Two patients had further deterioration in their diplopia following surgery. CONCLUSION: Our technique of a combined ETFD with ETMOWD appears to be effective in managing patients with DON, with minimal morbidities and a low incidence of postoperative diplopia. SN - 1460-2202 UR - https://www.unboundmedicine.com/medline/citation/25835075/Endoscopical_Orbital_Fat_Decompression_with_Medial_Orbital_Wall_Decompression_for_Dysthyroid_Optic_Neuropathy_ L2 - http://www.tandfonline.com/doi/full/10.3109/02713683.2015.1008640 DB - PRIME DP - Unbound Medicine ER -