Isolated caruncular approach for orbital decompression.
OBJECTIVE
To evaluate the effectiveness of the isolated caruncular approach to orbital decompression of thyroid ophthalmopathy.


METHODS
In a retrospective, noncomparative, interventional case series, we reviewed the records of 29 patients (48 orbits) who had thyroid ophthalmopathy and had undergone orbital decompression using the caruncular approach. The medial wall was decompressed in two patients (three orbits), and the medial and inferior walls were decompressed in 27 patients (45 orbits).


RESULTS
The mean retrodisplacement achieved was 2.7 mm of decompression of the medial wall, and 4.2 mm of decompression of the medial and inferior walls. Diplopia arose in the primary position in 4 of 17 previously asymptomatic patients. Persistent postdecompression strabismus was managed successfully with adjustable strabismus surgery. Other complications were minimal, including a hypertrophic scar in one eye and a pyogenic granuloma in another.


CONCLUSIONS
Orbital decompression using the isolated caruncular approach offers rapid access to the medial and inferior orbital walls and makes graded decompression possible in each case. It is a useful approach for patients wishing surgery for cosmetic purposes and for those with compressive optic neuropathy as well.
Department of Ophthalmology, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kyung In
KI
Woo
Yoon-Duck
YD
Kim
D000293:Adolescent; D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D005143:Eyelids; D005260:Female; D006111:Graves Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D009915:Orbit / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed