Treatment of proptosis with fat removal orbital decompression in Graves' ophthalmopathy.
OBJECTIVE
Retrospective evaluation of 41 proptosis reduction procedures using fat removal orbital decompression (FROD) according to a modified Olivari's technique.


METHODS
Trans-septal excision of extraconal and intraconal fat was done under the microscope through the upper and lower eyelid blepharoplasty approach. Proptosis was measured with a Hertel exophthalmometer.


RESULTS
Mean excision of 7.31 + 1.9 ml (range 3.25-12 ml) of orbital fat reduced proptosis on average by 4.7 + 2.4 mm (range 1-11 mm). Side effects were few, limited only to ocular motility disturbances. There was no significant effect on visual fileds. A postoperative drop in IOP was noted in patients with preoperative IOP above 21 mmHg. Efficient palpebral lengthening can be achieved with combined section of the levator aponeurosis horns in the upper eyelid, and/or auricular cartilage graft in the lower eyelid.


CONCLUSIONS
FROD reduces proptosis in Grave's ophthalmopathy.
Adenis
J P
JP
Service d'Ophtalmologie, C.H.U. Dupuytren, Faculté de Médecine, Limoges, France. pradenis@unilim.Fr
Robert
P Y
PY
Lasudry
J G
JG
Dalloul
Z
Z
D000273:Adipose Tissue / Q000601:surgery*; D000328:Adult; D000368:Aged; D019882:Blepharoplasty; D019299:Decompression, Surgical / Q000379:methods*; D005094:Exophthalmos / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005133:Eye Movements; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome