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Results of diplopia and strabismus in patients with severe thyroid ophthalmopathy after orbital decompression.

Roncevic R, Savkovic Z, Roncevic D - Indian J Ophthalmol (2014)

Bottom Line: All patients showed a significant reduction of exophthalmos [5-11 mm, 7.2 mm on average], reduction of intraocular pressure, marked improvement in ocular muscle function as well as considerable reduction in or disappearance of subjective symptoms.There was an improvement in vision in 68% patients who had impaired vision before the operation.Less evident relapse of exophthalmos was recorded in 3 cases only and only one patient required unilateral reoperation.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Revida Hospital, Belgrade, Serbia.

ABSTRACT

Purpose: It has been frequently stated that the orbital decompression, in patients with thyroid ophthalmopathy, does not usually improve extraocular muscles function and that after the operation there is often a deterioration of these functions. The purpose of this article is evaluation of extraocular muscles function after applying personal method of 3 wall orbital decompression.

Materials and methods: Retrospective review of case records of 119 patients with severe thyroid ophthalmopathy seen and treated by the author between December 1986 and December 2010. All patents underwent 3 wall orbital decompression combined with removal of the periorbital, intraorbital and retrobulbar fat. Correction of coexistent eyelid retraction and deformities were also performed.

Results: Comparison of preoperative and postoperative results was conducted in 65 patients three months after 3 wall decompression. All patients showed a significant reduction of exophthalmos [5-11 mm, 7.2 mm on average], reduction of intraocular pressure, marked improvement in ocular muscle function as well as considerable reduction in or disappearance of subjective symptoms. There were no cases of subsequent impairment of ocular motility. Strabismus surgery was performed in 6 patients with residual diplopia. There was an improvement in vision in 68% patients who had impaired vision before the operation. Less evident relapse of exophthalmos was recorded in 3 cases only and only one patient required unilateral reoperation.

Conclusion: It can be concluded that this method of orbital decompression is logical, based on an understanding of the pathology, has less complication rates, is relatively easy to perform, gives very good functional and aesthetic long term results and allows rapid recovery.

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Patient after thyroidectomy with exophthalmos of 32 mm and with eyelid retraction and deformities [changes on the eyes are worsened after thyroidectomy] before (a) and 3 months after operation (b), without diplopia
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Figure 6: Patient after thyroidectomy with exophthalmos of 32 mm and with eyelid retraction and deformities [changes on the eyes are worsened after thyroidectomy] before (a) and 3 months after operation (b), without diplopia


Results of diplopia and strabismus in patients with severe thyroid ophthalmopathy after orbital decompression.

Roncevic R, Savkovic Z, Roncevic D - Indian J Ophthalmol (2014)

Patient after thyroidectomy with exophthalmos of 32 mm and with eyelid retraction and deformities [changes on the eyes are worsened after thyroidectomy] before (a) and 3 months after operation (b), without diplopia
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061660&req=5

Figure 6: Patient after thyroidectomy with exophthalmos of 32 mm and with eyelid retraction and deformities [changes on the eyes are worsened after thyroidectomy] before (a) and 3 months after operation (b), without diplopia
Bottom Line: All patients showed a significant reduction of exophthalmos [5-11 mm, 7.2 mm on average], reduction of intraocular pressure, marked improvement in ocular muscle function as well as considerable reduction in or disappearance of subjective symptoms.There was an improvement in vision in 68% patients who had impaired vision before the operation.Less evident relapse of exophthalmos was recorded in 3 cases only and only one patient required unilateral reoperation.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Revida Hospital, Belgrade, Serbia.

ABSTRACT

Purpose: It has been frequently stated that the orbital decompression, in patients with thyroid ophthalmopathy, does not usually improve extraocular muscles function and that after the operation there is often a deterioration of these functions. The purpose of this article is evaluation of extraocular muscles function after applying personal method of 3 wall orbital decompression.

Materials and methods: Retrospective review of case records of 119 patients with severe thyroid ophthalmopathy seen and treated by the author between December 1986 and December 2010. All patents underwent 3 wall orbital decompression combined with removal of the periorbital, intraorbital and retrobulbar fat. Correction of coexistent eyelid retraction and deformities were also performed.

Results: Comparison of preoperative and postoperative results was conducted in 65 patients three months after 3 wall decompression. All patients showed a significant reduction of exophthalmos [5-11 mm, 7.2 mm on average], reduction of intraocular pressure, marked improvement in ocular muscle function as well as considerable reduction in or disappearance of subjective symptoms. There were no cases of subsequent impairment of ocular motility. Strabismus surgery was performed in 6 patients with residual diplopia. There was an improvement in vision in 68% patients who had impaired vision before the operation. Less evident relapse of exophthalmos was recorded in 3 cases only and only one patient required unilateral reoperation.

Conclusion: It can be concluded that this method of orbital decompression is logical, based on an understanding of the pathology, has less complication rates, is relatively easy to perform, gives very good functional and aesthetic long term results and allows rapid recovery.

Show MeSH
Related in: MedlinePlus