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Study finds mixed results for orbital decompression
A new study in Ophthalmic Plastic & Reconstructive Surgery has demonstrated that orbital decompression can both resolve and cause diplopia in patients with thyroid-related orbitopathy.
Mainville and colleagues found that a significant number of patients experienced complete diplopia resolution and a significant number of patients experienced new-onset diplopia following orbital decompression, according to the study.
Researchers analyzed 217 orbits in 123 patients between 1999 and 2008, noting the clinical indication for decompression surgery, the presence of diplopia both before and after surgery as well as the surgical technique in each patient, as detailed in the study.
Results showed that 26% of patients displayed diplopia before surgery, and 40.7% displayed diplopia after. Of the 26% patients with diplopia before surgery, 28.1% experienced complete resolution, while 65.5% stayed stable, and 6.3% worsened. They also found that 29.7% of patients experienced new-onset diplopia, and 40% of those patients had their periorbita opened.
"It has previously been reported in the literature that orbital decompression for thyroid-related orbitopathy can cause diplopia in a significant number of cases," the authors wrote in their conclusion. "This provides the rational for performing orbital decompression prior to strabismus surgery in the management of thyroid-related orbitopathy.”
The authors added that the resolution of diplopia in a significant proportion of patients with preexisting diplopia is important in the preoperative discussion.
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Ophthal Plast Reconstr Surg. 2014;http://www.ncbi.nlm.nih.gov/pubmed/24481502