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Degree of preop proptosis determines extent of surgery
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LA JOLLA, Calif. — The amount of orbital decompression surgery needed in patients with thyroid eye disease can be guided by the severity of preop proptosis, according to a study here
Don Kikkawa, MD, and colleagues studied 39 orbits of 23 patients with thyroid-related orbitopathy in a retrospective, noncomparative interventional case series. Graded orbital decompression was performed based on the severity of preop exophthalmometry.
Mean proptosis reduction in all orbits was 6.4 mm. Proptosis reduction ranged from a mean of 4.8 mm in eyes with preop exophthalmometry of less than 22 mm to a mean of 8.9 mm in patients with exophthalmometry greater than 25 mm.
In four of five eyes with compressive optic neuropathy there was an improvement of best corrected visual acuity of 2 lines or more. Margin-to-reflex distance of the upper and lower lids and intraocular pressure were reduced in all groups. New-onset diplopia developed in two patients; 13 of 15 patients who had diplopia preoperatively had persistent diplopia postoperatively as well; the other two patients with preop diplopia had relief postop.
The study is published in the July issue of Ophthalmology.