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Long-term outcomes of orbital fat decompression in Graves' orbitopathy.
Br J Ophthalmol 2018; 102(1):69-73BJ

Abstract

PURPOSE

To evaluate the long-term clinical efficacy of orbital fat decompression in treating proptosis in Graves' ophthalmopathy (GO).

METHODS

Retrospective review of 1604 eyes of 845 patients with symmetric (1518 eyes) and asymmetric (86 eyes) proptosis who received orbital fat decompression between 2003 and 2014. Changes in Hertel values were evaluated at baseline, 6 months postoperatively and yearly thereafter. Recurrence of proptosis, diplopia and other complications that required additional surgeries were documented and analysed. The surgical outcome was defined as complete success if there was proptosis reduction with no recurrence and improved or no diplopia. Partial success was considered if there was proptosis reduction without recurrence yet persistent or new-onset diplopia. Failure was considered if there was recurrence of proptosis regardless of diplopia. The patient's quality of life was also evaluated as a long-term outcome.

RESULTS

After follow-up for 37.9±24.4 months, 1365 eyes (85.1%) achieved complete success, 219 eyes (13.7%) achieved partial success and 20 eyes (1.2%) had failure. Newly onset diplopia and secondary decompression occurrence rate remained low at 3.3% and 0.6%, respectively. The total proptosis reduction was 4.1±1.3 mm, which was consistent all through the intermediate and long-term (5-10 years) follow-up. The amount of orbital fat removal (4.5±1.1 mL) played a significant role in the long-term Hertel change. Importantly, the overall quality of life increased significantly for GO patients after undergoing orbital fat decompression.

CONCLUSIONS

Orbital fat decompression has a long-term efficacy in correcting disfiguring proptosis with a low complication rate and without the need of secondary decompression procedures. This was also associated with a significant improvement in quality of life.

Authors+Show Affiliations

Ocular Surface Center, Miami, Florida, USA. Florida International University, Herbert Wertheim College of Medicine, Miami, Florida, USA.Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.Ocular Surface Center, Miami, Florida, USA. Florida International University, Herbert Wertheim College of Medicine, Miami, Florida, USA.Ocular Surface Center, Miami, Florida, USA. Florida International University, Herbert Wertheim College of Medicine, Miami, Florida, USA.Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan. School of Medicine, National Taiwan University, Taipei, Taiwan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28450378

Citation

Cheng, Anny M., et al. "Long-term Outcomes of Orbital Fat Decompression in Graves' Orbitopathy." The British Journal of Ophthalmology, vol. 102, no. 1, 2018, pp. 69-73.
Cheng AM, Wei YH, Tighe S, et al. Long-term outcomes of orbital fat decompression in Graves' orbitopathy. Br J Ophthalmol. 2018;102(1):69-73.
Cheng, A. M., Wei, Y. H., Tighe, S., Sheha, H., & Liao, S. L. (2018). Long-term outcomes of orbital fat decompression in Graves' orbitopathy. The British Journal of Ophthalmology, 102(1), pp. 69-73. doi:10.1136/bjophthalmol-2016-309888.
Cheng AM, et al. Long-term Outcomes of Orbital Fat Decompression in Graves' Orbitopathy. Br J Ophthalmol. 2018;102(1):69-73. PubMed PMID: 28450378.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcomes of orbital fat decompression in Graves' orbitopathy. AU - Cheng,Anny M, AU - Wei,Yi-Hsuan, AU - Tighe,Sean, AU - Sheha,Hosam, AU - Liao,Shu-Lang, Y1 - 2017/04/27/ PY - 2016/11/08/received PY - 2017/03/29/revised PY - 2017/04/09/accepted PY - 2017/4/30/pubmed PY - 2017/12/27/medline PY - 2017/4/29/entrez KW - Decompression KW - Diplopia KW - Graves Ophthalmopathy KW - Orbital fat KW - Proptosis SP - 69 EP - 73 JF - The British journal of ophthalmology JO - Br J Ophthalmol VL - 102 IS - 1 N2 - PURPOSE: To evaluate the long-term clinical efficacy of orbital fat decompression in treating proptosis in Graves' ophthalmopathy (GO). METHODS: Retrospective review of 1604 eyes of 845 patients with symmetric (1518 eyes) and asymmetric (86 eyes) proptosis who received orbital fat decompression between 2003 and 2014. Changes in Hertel values were evaluated at baseline, 6 months postoperatively and yearly thereafter. Recurrence of proptosis, diplopia and other complications that required additional surgeries were documented and analysed. The surgical outcome was defined as complete success if there was proptosis reduction with no recurrence and improved or no diplopia. Partial success was considered if there was proptosis reduction without recurrence yet persistent or new-onset diplopia. Failure was considered if there was recurrence of proptosis regardless of diplopia. The patient's quality of life was also evaluated as a long-term outcome. RESULTS: After follow-up for 37.9±24.4 months, 1365 eyes (85.1%) achieved complete success, 219 eyes (13.7%) achieved partial success and 20 eyes (1.2%) had failure. Newly onset diplopia and secondary decompression occurrence rate remained low at 3.3% and 0.6%, respectively. The total proptosis reduction was 4.1±1.3 mm, which was consistent all through the intermediate and long-term (5-10 years) follow-up. The amount of orbital fat removal (4.5±1.1 mL) played a significant role in the long-term Hertel change. Importantly, the overall quality of life increased significantly for GO patients after undergoing orbital fat decompression. CONCLUSIONS: Orbital fat decompression has a long-term efficacy in correcting disfiguring proptosis with a low complication rate and without the need of secondary decompression procedures. This was also associated with a significant improvement in quality of life. SN - 1468-2079 UR - https://www.unboundmedicine.com/medline/citation/28450378/Long_term_outcomes_of_orbital_fat_decompression_in_Graves'_orbitopathy_ L2 - http://bjo.bmj.com/cgi/pmidlookup?view=long&pmid=28450378 DB - PRIME DP - Unbound Medicine ER -