[Clinical course and prognosis of diplopias after orbital bony wall decompression for thyroid related orbitopathy].
BACKGROUND
The aim of this study was to assess how oculomotor complications progress after orbital bony decompression for dysthyroid orbitopathy and to assess the residual risk of consecutive diplopia.


METHODS
The medial orbital wall and floor were decompressed by a transpalpebral approach in 77 patients (117 orbits). Indications for decompression were optic neuropathy in 22 patients, exposure of the cornea in 1 patient, and cosmetic rehabilitation in 54 patients. Occurrence of oculomotor disorder after surgery was noted and the clinical course after a one-year follow-up was studied.


RESULTS
Diplopia was observed in 34 patients (44%): 18 of these patients were treated by external orbital radiotherapy before surgery. Diplopia decreased spontaneously over a period ranging from 15 days to 2 months or was treated by adequate prism in 22 cases. A higher degree of diplopia (12 to 30 diopters) was noted in 12 cases, requiring surgical care that was successful in all cases. This progress was especially observed in patients with optic neuropathy or in patients who had been previously treated with external orbital radiotherapy.


CONCLUSIONS
Prognosis of diplopia after bony wall decompression for thyroid-related orbitopathy can be favorable with spontaneous reduction, prism, or surgical treatment. Precise information should be given to the patients before surgery.
George
J L
JL
Service ophtalmologie B - Unité oculoplastique et oculomotrice, CHU Nancy-Brabois, 1, rue du Morvan, 54511 Vandoeuvre-les-Nancy Cedex, France.
Tercero
M E
ME
Maalouf
T
T
Angioï-Duprez
K
K
D000328:Adult; D000368:Aged; D004172:Diplopia / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006111:Graves Disease / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000601:surgery; D009915:Orbit / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis