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Spare the floor in thyroid eye surgery to avoid diplopia, surgeons say
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Performing medial and lateral wall surgery only, sparing the orbital floor, may reduce diplopia rates after surgery for orbital decompression in thyroid eye disease, a study found.
Scott Graham, MD, and colleagues at the University of Iowa retrospectively reviewed medial and lateral orbital wall surgeries with sparing of the orbital floor for orbital decompression of thyroid eye disease. They identified 63 consecutive surgeries in 40 patients. The average patient age was 51. Mean time of follow-up was 32 months.
The medial wall was approached by transcaruncular technique in 59 surgeries and endoscopic technique in the remaining four. Average exophthalmos improvement was 4.1 mm. Palpebral fissure improvement ranged from 0 to 7 mm. New-onset diplopia occurred in four patients (10%), of whom two required strabismus surgery.
The study is published in the July issue of The Laryngoscope.