Results of transantral orbital decompression in patients with thyroid-associated ophthalmopathy.
OBJECTIVE
To present the results of orbital decompression in patients with thyroid-associated ophthalmopathy (TAO).


METHODS
Transantral orbital decompression was performed in 63 patients with TAO. In 40 patients (63%) the operation was made because of progressive ophthalmopathy not responding to medical therapy, and in 23 patients (37%) the operation was made for rehabilitative reasons. The long-term hypesthesia engaging the infraorbital nerve was assessed with a questionnaire using a Visual Analogue Scale (VAS).


RESULTS
The mean proptosis reduction was 3.2 mm (range 0-8 mm). Twenty-one patients had impaired visual acuity preoperatively, and 20 improved. Altogether 30 patients (40%) had worsened ocular motility postoperatively. Forty-three patients did not have diplopia in the primary position preoperatively, and new diplopia developed in 22 of these (51%). Hypesthesia in the infraorbital nerve area was reported for half of the operated sides, but was a major cause of distress (VAS-scoring >5) to eleven patients.


CONCLUSIONS
Transantral orbital decompression is indicated in patients with progressive TAO or in patients with prominent exophthalmos, and results in a good proptosis reduction, but the risk of postoperative diplopia is significant. Postoperative hypesthesia is common but often not a major problem.
Tallstedt
L
L
St. Erik's Eye Hospital, Stockholm, Sweden. leif.tallstedt@ophste.hs.sll.se
Papatziamos
G
G
Lundblad
L
L
Anggård
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000379:methods*; D005123:Eye / Q000294:innervation; D005260:Female; D006111:Graves Disease / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006987:Hypesthesia / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000209:etiology / Q000503:physiopathology; D009915:Orbit / Q000294:innervation / Q000601:surgery*; D010147:Pain Measurement; D011183:Postoperative Complications; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014792:Visual Acuity