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Orbital decompression surgery for the treatment of Graves' ophthalmopathy: comparison of different techniques and long-term results.
Int J Ophthalmol 2018; 11(8):1363-1370IJ

Abstract

AIM

To evaluate the long-term results of different orbital decompression techniques performed in patients with Graves' ophthalmopathy (GO).

METHODS

Totally 170 cases with GO underwent orbital decompression between 1994 and 2014. Patients were divided into 4 groups as medial-inferior, medial-lateral (balanced), medial-lateral-inferior, and lateral only according to the applied surgical technique. Surgical indications, regression degrees on Hertel exophthalmometer, new-onset diplopia in the primary gaze and new-onset gaze-evoked diplopia after surgery and visual acuity in cases with dysthyroid optic neuropathy (DON) were compared between different surgical techniques.

RESULTS

The study included 248 eyes of 149 patients. The mean age for surgery was 42.3±13.2y. DON was the surgical indication in 36.6% of cases, and three-wall decompression was the most preferred technique in these cases. All types of surgery significantly decrease the Hertel values (P<0.005). Balanced medial-lateral, and only lateral wall decompression caused the lowest rate of postoperative new-onset diplopia in primary gaze. The improvement of visual acuity in patients with DON did not significantly differ between the groups (P=0.181).

CONCLUSION

The study show that orbital decompression surgery has safe and effective long term results for functional and cosmetic rehabilitation of GO. It significantly reduces Hertel measurements in disfiguring proptosis and improves visual functions especially in DON cases.

Authors+Show Affiliations

Istanbul Education and Research Hospital, Istanbul 34098, Turkey.Department of Ophthalmology, Gazi University School of Medicine, Besevler, Ankara 06500, Turkey.Dunya Goz Hospital, Ankara 06500, Turkey.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30140642

Citation

Cubuk, Mehmet Ozgur, et al. "Orbital Decompression Surgery for the Treatment of Graves' Ophthalmopathy: Comparison of Different Techniques and Long-term Results." International Journal of Ophthalmology, vol. 11, no. 8, 2018, pp. 1363-1370.
Cubuk MO, Konuk O, Unal M. Orbital decompression surgery for the treatment of Graves' ophthalmopathy: comparison of different techniques and long-term results. Int J Ophthalmol. 2018;11(8):1363-1370.
Cubuk, M. O., Konuk, O., & Unal, M. (2018). Orbital decompression surgery for the treatment of Graves' ophthalmopathy: comparison of different techniques and long-term results. International Journal of Ophthalmology, 11(8), pp. 1363-1370. doi:10.18240/ijo.2018.08.18.
Cubuk MO, Konuk O, Unal M. Orbital Decompression Surgery for the Treatment of Graves' Ophthalmopathy: Comparison of Different Techniques and Long-term Results. Int J Ophthalmol. 2018;11(8):1363-1370. PubMed PMID: 30140642.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Orbital decompression surgery for the treatment of Graves' ophthalmopathy: comparison of different techniques and long-term results. AU - Cubuk,Mehmet Ozgur, AU - Konuk,Onur, AU - Unal,Mehmet, Y1 - 2018/08/18/ PY - 2017/08/22/received PY - 2018/01/03/accepted PY - 2018/8/25/entrez PY - 2018/8/25/pubmed PY - 2018/8/25/medline KW - Graves' ophthalmopathy KW - dysthyroid optic neuropathy KW - orbital decompression SP - 1363 EP - 1370 JF - International journal of ophthalmology JO - Int J Ophthalmol VL - 11 IS - 8 N2 - AIM: To evaluate the long-term results of different orbital decompression techniques performed in patients with Graves' ophthalmopathy (GO). METHODS: Totally 170 cases with GO underwent orbital decompression between 1994 and 2014. Patients were divided into 4 groups as medial-inferior, medial-lateral (balanced), medial-lateral-inferior, and lateral only according to the applied surgical technique. Surgical indications, regression degrees on Hertel exophthalmometer, new-onset diplopia in the primary gaze and new-onset gaze-evoked diplopia after surgery and visual acuity in cases with dysthyroid optic neuropathy (DON) were compared between different surgical techniques. RESULTS: The study included 248 eyes of 149 patients. The mean age for surgery was 42.3±13.2y. DON was the surgical indication in 36.6% of cases, and three-wall decompression was the most preferred technique in these cases. All types of surgery significantly decrease the Hertel values (P<0.005). Balanced medial-lateral, and only lateral wall decompression caused the lowest rate of postoperative new-onset diplopia in primary gaze. The improvement of visual acuity in patients with DON did not significantly differ between the groups (P=0.181). CONCLUSION: The study show that orbital decompression surgery has safe and effective long term results for functional and cosmetic rehabilitation of GO. It significantly reduces Hertel measurements in disfiguring proptosis and improves visual functions especially in DON cases. SN - 2222-3959 UR - https://www.unboundmedicine.com/medline/citation/30140642/Orbital_decompression_surgery_for_the_treatment_of_Graves'_ophthalmopathy:_comparison_of_different_techniques_and_long_term_results_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/30140642/ DB - PRIME DP - Unbound Medicine ER -