Orbital decompression in Graves' disease.
OBJECTIVE
The authors' experience with surgical decompression of the orbits in patients with Graves' orbitopathy is reviewed.


METHODS
One hundred twenty-six consecutive primary orbital decompressions were retrospectively studied.


METHODS
Tertiary care university hospitals.


METHODS
All patients were referred by ophthalmologists for surgical decompression after failure of a trial of oral steroid therapy, and many had had orbital irradiation.


METHODS
Antral-ethmoidal or transconjunctival surgical decompression was accomplished in all.


RESULTS
Measurements of visual acuity, ocular motility, and proptosis were accomplished preoperatively and a minimum of 3 months postoperatively. Surgical complications were tallied.


RESULTS
Mean reduction of proptosis by antral-ethmoidal decompression was 5.3 mm, and 3.6 mm by the transconjunctival approach. Visual acuity improved in 34 orbits, was unchanged in 91 orbits, and decreased in one orbit. In a subgroup of 30 patients in whom ocular motility was quantified by prism cover test preoperatively, motility was unchanged or improved in 21 and was decreased in nine. Complications were infrequent.


CONCLUSIONS
The antral-ethmoidal and transconjunctival approaches to orbital decompression are safe and effective.
Weisman
R A
RA
Division of Head and Neck Surgery, University of California-San Diego School of Medicine.
Osguthorpe
J D
JD
D000293:Adolescent; D000328:Adult; D000368:Aged; D003228:Conjunctiva / Q000601:surgery; D004172:Diplopia / Q000503:physiopathology / Q000601:surgery; D005004:Ethmoid Bone / Q000601:surgery; D005094:Exophthalmos / Q000503:physiopathology / Q000601:surgery*; D005133:Eye Movements / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000601:surgery*; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery; D008875:Middle Aged; D009915:Orbit / Q000601:surgery*; D010292:Paresthesia / Q000209:etiology; D011183:Postoperative Complications; D011446:Prospective Studies; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology